Cardiovascular Complications of Cancer Therapy

Abstract

Modern cancer therapy has successfully cured many cancers and converted a terminal illness to chronic disease. Because cancer patients often have co-existing heart diseases, expert advice from the cardiologists will improve clinical outcome. In addition, cancer therapy can also cause myocardial damage, induce endothelial dysfunction, and alter cardiac conduction. Thus, it is important for practicing cardiologists to be knowledgeable about the diagnosis, prevention, and management of cardiovascular complications of cancer therapy. In this first part of a 2-part review, we will review cancer therapy-induced cardiomyopathy and ischemia. This review is based on MEDLINE literature search, published clinical guidelines, and best practices in major cancer centers. With the number of cancer survivors expanding quickly, the time has come for cardiologists to work closely with cancer specialists to prevent and treat cancer therapy-induced cardiovascular complications.

Sårbarhetsfaktorer hos eldre med kreft

“…Antall med avrundet prosentandel i parentes der annet ikke er oppgitt. Medikamentell kreftbehandling er forbundet med økt risiko for kardiovaskulaere tilstander, både akutt og som ledd i senskader (13,14). Det at hele 43 % i vårt materiale hadde etablert kardiovaskulaer sykdom allerede ved førstegangskonsultasjonen, tilsier at det er behov for å forebygge slike komplikasjoner og at en del pasienter sannsynligvis vil kunne profittere på systematisk samarbeid mellom onkologer og kardiologer.…”

The Impact of Pazopanib on the Cardiovascular System

“…Pazopanib inhibition of VEGF signaling may also increase blood viscosity through overproduction of erythropoietin, exacerbating risk for thrombosis. 113,114 …”

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

“…Recently, Mehta et al (2018) highlighted those CVRFs that overlap with risk factors for breast cancer ; see Table 1, Figure 1). Cardiovascular risk factors can be enhanced during cancer treatment and lead to an increased risk of coronary artery disease (CAD) in survivors (Chang, Moudgil, Scarabelli, Okwuosa, & Yeh, 2017a;Chang, Okwuosa, Scarabelli, Moudgil & Yeh, 2017b;Darby et al, 2013;Greenlee et al, 2017;Hague et al, 2014;Marmagkiolis et al, 2016;Weaver, Jessup, & Mayer, 2013). Increased CVD morbidity and mortality may be attributed to preexisting CVD in newly diagnosed cancer patients, cardiotoxicity resulting in decreased ventricular function, and treatment effects that result in increased CVRFs such as dyslipidemia, hypertension, central adiposity, and metabolic syndrome (Azard & Denmark-Wahnefried, 2014;Cespedes Feliciano et al, 2016;Coviello, Knobf, & Laclergue, 2013;Gristina et al, 2015;Simon et al, 2018).…”