Cardiotoxicity From the cardiologist’s Perspective

Codon, J Caro; Rodriguez, S O Rosillo; Fernández, Teresa López

doi:10.2217/fca.15.47

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…The cardiovascular system is often affected by various cancer drug therapies (e.g., anthracyclines, monoclonal antibodies, fluoropyrimidines, taxanes, alkylating agents, vinka alkaloids, and angiogenesis inhibitors) [ 35 , 36 , 37 ]. Cardiac toxicity can become chronic, with significant irreversible morbidity and even mortality [ 38 , 39 , 40 ]. The diagnostic imaging techniques that can be used to assess cardiac toxicity include echocardiography, scintigraphy, CT, and MRI [ 41 , 42 , 43 , 44 ].…”

Section: Cardiac Toxicitymentioning

confidence: 99%

The Use of Imaging in the Prediction and Assessment of Cancer Treatment Toxicity

Jadvar

2017

Diagnostics

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Multimodal imaging is commonly used in the management of patients with cancer. Imaging plays pivotal roles in the diagnosis, initial staging, treatment response assessment, restaging after treatment and the prognosis of many cancers. Indeed, it is difficult to imagine modern precision cancer care without the use of multimodal molecular imaging, which is advancing at a rapid pace with innovative developments in imaging sciences and an improved understanding of the complex biology of cancer. Cancer therapy often leads to undesirable toxicity, which can range from an asymptomatic subclinical state to severe end organ damage and even death. Imaging is helpful in the portrayal of the unwanted effects of cancer therapy and may assist with optimal clinical decision-making, clinical management, and overall improvements in the outcomes and quality of life for patients.

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Section: Cardiac Toxicitymentioning

confidence: 99%

The Use of Imaging in the Prediction and Assessment of Cancer Treatment Toxicity

Jadvar

2017

Diagnostics

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“…Typical CTX is characterized by left ventricular dysfunction secondary to the use of anthracyclines, a common class of drugs used in the treatment of breast cancer, acute leukemia, and lymphoma [ 1 – 3 ]. This condition influences the prognosis of patients undergoing chemotherapy; hence, it can lead to delayed or interrupted treatment, with an unfavorable impact on the morbidity and mortality of cancer patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic strategy for early detection of cardiotoxicity of doxorubicin: a prospective observational study

et al. 2022

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Background Cancer chemotherapy using anthracyclines is associated with cardiotoxicity (CTX), and left ventricular ejection fraction (LVEF) analysis is not sensitive to early cardiotoxic changes. Left ventricular global longitudinal strain (LV GLS) monitoring helps screen subclinical CTX; however, the intervals at which it should be performed remain unclear. We aimed to evaluate the incidence of CTX in women with breast cancer and the associated factors and compare two echocardiographic monitoring strategies using two cutoff points for LV GLS variation. Methods Patients with breast cancer prescribed doxorubicin underwent serial LVEF and LV GLS assessments using two-dimensional echocardiography every 3 weeks for 6 months. Results We included 43 women; none developed a clinical CTX. Considering a relative reduction of LV GLS > 15%, subclinical CTX was present in 12 (27.9%) and six (14%) patients at 3-week and 3-month intervals, respectively (P = 0.28). Additionally, considering a reduction of > 12%, subclinical CTX was present in 17 (39.5%) and 10 (23.3%) patients (P = 0.16), respectively. There were no significant differences in either reference value at 3-week (P = 0.19) and 3-month intervals (P = 0.41). Age ≥ 60 years (P = 0.018) and hypertension (HTN) (P = 0.022) were associated with subclinical CTX in the univariate analysis. Conclusions There was no difference in the incidence of subclinical CTX between the two cutoff points and no benefit in performing echocardiography every 3 weeks compared with quarterly monitoring. Advanced age and HTN were associated with the development of subclinical CTX.

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“…This condition in uences the prognosis of patients undergoing chemotherapy; hence, it can lead to delayed or interrupted treatment, with an unfavorable impact on the morbidity and mortality of cancer patients. [4] Anthracyclines increase the release of reactive oxygen species, change iron metabolism, and inhibit the enzyme topoisomerase 2ß, thus causing mitochondrial dysfunction and impairment of DNA repair, replication and transcription; therefore, culminating in cardiomyocyte death. [2,3] Traditionally, CTX is monitored by the serial measurement of left ventricular ejection fraction (LVEF) using transthoracic echocardiography (TTE).…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic strategy for early detection of cardiotoxicity of doxorubicin: A prospective observational study

Sampaio

Silva

Frota

et al. 2022

Preprint

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Background Cancer chemotherapy using anthracyclines is associated with cardiotoxicity (CTX), and left ventricular ejection fraction (LVEF) analysis is not sensitive to early cardiotoxic changes. Global longitudinal strain (GLS) monitoring helps screen subclinical CTX; however, the intervals at which it should be performed remain unclear. We aimed to evaluate the incidence of CTX in women with breast cancer and the associated factors and compare two echocardiographic monitoring strategies using two cutoff points for GLS variation. Methods Patients with breast cancer prescribed doxorubicin underwent serial LVEF and GLS assessments using two-dimensional echocardiography every 3 weeks for 6 months. Results We included 43 women; none developed a clinical CTX. Considering a percentage reduction in absolute GLS value of > 15%, subclinical CTX was present in 12 (27.9%) and six (14%) patients at 3-week and 3-month intervals, respectively (P = 0.28). Additionally, considering a reduction of > 12%, subclinical CTX was present in 17 (39.5%) and 10 (23.3%) patients (P = 0.16), respectively. There were no significant differences in either reference value at 3-week (P = 0.19) and 3-month intervals (P = 0.41). Age ≥ 60 years (P = 0.018) and hypertension (HTN) (P = 0.022) were associated with subclinical CTX in the univariate analysis. Conclusions There was no difference in the incidence of subclinical CTX between the two cutoff points and no benefit in performing echocardiography every 3 weeks compared with quarterly monitoring. Advanced age and HTN were associated with the development of subclinical CTX.

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Cardiotoxicity From the cardiologist’s Perspective

Cited by 5 publications

References 35 publications

The Use of Imaging in the Prediction and Assessment of Cancer Treatment Toxicity

The Use of Imaging in the Prediction and Assessment of Cancer Treatment Toxicity

Echocardiographic strategy for early detection of cardiotoxicity of doxorubicin: a prospective observational study

Echocardiographic strategy for early detection of cardiotoxicity of doxorubicin: A prospective observational study

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