Cardiovascular morbidity in long-term survivors of metastatic testicular cancer.

Left ventricular and cardiac autonomic function in survivors of testicular cancer

“…These data suggest that the development of cardiac dysfunction following chemotherapy for testicular cancer is associated with hypertension. Furthermore, chemotherapy may adversely affect left ventricular function, either directly or by raising the prevalence of cardiovascular risk factors other than hypertension, such as obesity, dyslipidaemia and insulin resistance, which have all been reported in survivors of testicular cancer [1,4,5]. Systolic left ventricular function was normal in most patients.…”

“…Long-term survivors of disseminated testicular cancer, cured by cisplatin-and bleomycin-containing chemotherapy, have an increased risk for cardiovascular disease [1][2][3]. The mechanisms behind this are unknown.…”

“…The mechanisms behind this are unknown. Cardiovascular risk factors, like hypertension, dyslipidaemia and insulin resistance, develop frequently and may induce accelerated atherosclerosis and early vasculopathy [1,4,5]. Hypogonadism or direct effects of cisplatin and bleomycin on the vasculature may be involved.…”

Cardiac toxicity in cancer survivors

“…Given the potentially long interval (up to 2 or 3 decades in some instances) between cancer therapy exposure (both chemotherapy and radiotherapy) and subsequent adverse, measurable effects on cardiac health, such adverse effects can have an important, albeit delayed effect on the prognosis of long-term survivors. 2,4,9,19,20 It has been difficult even to develop a consensus for a more specific outcome, such as LV dysfunction, including identifying the most sensitive markers and the most appropriate threshold for action. LV dysfunction may result from many anticancer drugs through different mechanisms and may manifest as declined LVEF as a final common pathway.…”

“…Over the past 10 to 15 years, cardiac complications resulting from cancer therapy have been recognized increasingly as major contributors to morbidity and, ultimately, mortality in cancer survivors. [1][2][3][4][5][6] However, despite this increased recognition, there are major limitations in our collective understanding of the proper tools necessary for the identification, treatment, or prevention of these complications. Although many systematic reviews have been conducted with regard to various topics related to cardiac disease in this population (and are referenced in the current article), this "dialogue" between European and American investigators will provide insight to some of the current perspectives in Europe and the United States on viewing and managing this burgeoning issue.…”