Cardio-Oncology has blossomed as a new field in cardiovascular medicine, in large part due to new therapies, which may have cardiovascular sequelae. Despite this, anthracyclines still serve as cornerstone therapy for most pediatric cancers, several solid tumors and hematological malignancies. Cardiotoxicity is the main limiting concern with anthracyclines, and this is particularly an issue in patients in extremes of age (both young and old patients). Pediatric hearts are susceptible for cardiotoxicity, while in older patients, concomitant risk factors may contribute to lower threshold for cardiotoxic effects. With increasing patient survival, a significant increase in elderly cancer patients and long-term cardiotoxicity effects of anthracyclines, a better mechanistic understanding of age-dependent processes—that define cardiotoxicity—is needed. This review sheds light on how age affects underlying molecular pathways of anthracycline-associated cardiotoxicity and aims to provide preventive strategies that can be used in clinical practice.

心血管肿瘤学作为心血管医学的一个新领域蓬勃发展，这在很大程度上归功于可能有心血管后遗症的新疗法。尽管如此，蒽环类药物仍然是大多数儿科癌症、几种实体瘤和血液系统恶性肿瘤的基石疗法。心脏毒性是蒽环类药物的主要限制问题，这在极端年龄的患者（年轻和老年患者）中尤其是一个问题。小儿心脏易受心脏毒性影响，而在老年患者中，伴随的危险因素可能有助于降低心脏毒性效应的阈值。随着患者存活率的提高、老年癌症患者的显着增加和蒽环类药物的长期心脏毒性作用，需要更好地了解年龄依赖性过程（定义心脏毒性）的机制。