The number of childhood cancer survivors is increasing rapidly. According to American Association for Cancer Research, there are more than 750,000 childhood cancer survivors in the United States and Europe. As the number of childhood cancer survivors increases, so does cancer treatment-related cardiac dysfunction (CTRCD), leading to heart failure (HF). It has been reported that childhood cancer survivors who received anthracyclines are 15 times more likely to have late cancer treatment-related HF and have a 5-fold higher risk of death from cardiovascular (CV) disease than the general population. CV disease is the leading cause of death in childhood cancer survivors. The increasing need to manage cancer survivor patients has led to the rapid creation and adaptation of cardio-oncology. Cardio-oncology is a multidisciplinary science that monitors, treats, and prevents CTRCD. Many guidelines and position statements have been published to help diagnose and manage CTRCD, including those from the American Society of Clinical Oncology, the European Society of Cardiology, the Canadian Cardiovascular Society, the European Society of Medical Oncology, the International Late Effects of Childhood Cancer Guideline Harmonization Group, and many others. However, there remains a gap in identifying high-risk patients likely to develop cardiomyopathy and HF in later life, thus reducing primary and secondary measures being instituted, and when to start treatment when there is echocardiographic evidence of left ventricular (LV) dysfunctions without symptoms of HF. There are no randomized controlled clinical trials for treatment for CTRCD leading to HF in childhood cancer survivors. The treatment of HF due to cancer treatment is similar to the guidelines for general HF. This review describes the latest pharmacologic therapy for preventing and treating LV dysfunction and HF in childhood cancer survivors based on expert consensus guidelines and extrapolating data from adult HF trials.

儿童癌症幸存者的数量正在迅速增加。据美国癌​​症研究协会称，美国和欧洲有超过 750,000 名儿童癌症幸存者。随着儿童癌症幸存者数量的增加，癌症治疗相关的心功能障碍 (CTRCD) 也在增加，从而导致心力衰竭 (HF)。据报道，接受蒽环类药物治疗的儿童癌症幸存者患晚期癌症治疗相关心力衰竭的可能性是普通人群的 15 倍，死于心血管 (CV) 疾病的风险是普通人群的 5 倍。心血管疾病是儿童癌症幸存者死亡的主要原因。管理癌症幸存者患者的需求不断增加，导致心脏肿瘤学的快速创建和适应。心脏肿瘤学是一门多学科科学，用于监测、治疗和预防 CTRCD。已经发布了许多指南和立场声明来帮助诊断和管理 CTRCD，包括来自美国临床肿瘤学会、欧洲心脏病学会、加拿大心血管学会、欧洲肿瘤内科学会、国际儿童癌症晚期影响学会的指南和立场声明指南协调小组等。然而，在识别晚年可能患心肌病和心力衰竭的高危患者方面仍存在差距，从而减少正在采取的主要和次要措施，以及当超声心动图证据显示无症状的左心室 (LV) 功能障碍时何时开始治疗高频。目前还没有针对导致儿童癌症幸存者出现心力衰竭的 CTRCD 治疗的随机对照临床试验。癌症治疗引起的心力衰竭的治疗与一般心力衰竭的指南相似。本综述根据专家共识指南和成人心力衰竭试验的推断数据，描述了预防和治疗儿童癌症幸存者左心室功能障碍和心力衰竭的最新药物疗法。