Immune checkpoint inhibitors (ICIs) represent a major advance in the treatment of cancer. Although clinical trials reported a low incidence of immune-related cardiovascular adverse events,¹ the number of published life-threatening cases of cardiotoxicity is increasing.² In this descriptive observational analysis, we aimed to describe the clinical manifestations, management, and outcomes of patients who developed ICI-related cardiotoxicity.

The medical records of patients with a clinical suspicion of ICI-related cardiotoxicity were reviewed from the databases of 2 cardio-oncology units between March 2015 and April 2017. The patients are managed according to similar protocols. Because no specific follow-up had previously been established for patients receiving ICIs during the study period, the oncologists referred patients receiving ICIs only on the basis of their clinical suspicion of cardiovascular events. These patients had a standardized evaluation including clinical consultation, ECG, transthoracic echocardiography, and measurement of brain natriuretic peptide and troponin I serum levels. The management of cardiotoxicity was left to the physician’s discretion. The study was approved by our institutional review board, and informed consent has been obtained from the subjects. To create a pooled analysis, we also searched PubMed for English articles reporting cases of ICI-related cardiotoxicity until April 2017. We selected …

免疫检查点抑制剂（ICIs）代表了癌症治疗的重大进展。尽管临床试验报告了与免疫相关的心血管不良事件的发生率较低，但¹已发表的威胁生命的致命心脏毒性事件的数量正在增加。²在此描述性观察性分析中，我们旨在描述发生ICI相关心脏毒性的患者的临床表现，治疗和结局。

在2015年3月至2017年4月之间，从2个心脏肿瘤科的数据库中对临床怀疑患有ICI相关心脏毒性的患者的病历进行了审查。按照相似的方案对患者进行治疗。由于先前在研究期间尚未针对接受ICI的患者建立具体的随访，因此肿瘤科医生仅根据他们对心血管事件的临床怀疑才转诊接受ICI的患者。这些患者进行了标准化评估，包括临床咨询，心电图，经胸超声心动图检查以及脑钠肽和肌钙蛋白I血清水平的测量。心脏毒性的处理由医师自行决定。该研究已由我们的机构审查委员会批准，并且已从受试者中获得了知情同意。