Early Detection and Monitoring of Cancer Chemotherapy-Related Left Ventricular Dysfunction by Imaging Methods

Ribeiro, Mário Luiz; Jorge, Antônio José Lagoeiro; Nacif, Marcelo Souto; Martins, Wolney de Andrade

doi:10.5935/abc.20190022

Cited by 5 publications

(4 citation statements)

References 57 publications

(73 reference statements)

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“…However, there is still no conclusive evidence about the benefit of cardioprotective drugs. New research in the area is crucial to develop prevention and treatment strategies ( Ribeiro et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular adverse effects associated with the use of anti-HER2 in breast cancer treatment

Valente,

da Silva,

da Silva

et al. 2023

Front. Pharmacol.

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Background: Cancer represents an important public health problem with increasing incidence, prevalence, and mortality, affecting the entire Western population, especially in developed and developing countries. The use of monoclonal antibodies has revolutionized the treatment of cancer, but this treatment can cause adverse cardiovascular effects (AE).Objective: The objective of this paper is to identify and classify AE in breast cancer patients in the use of Trastuzumab in two health institutions.Methods: Retrospective study of medical records of patients with breast cancer Her 2+ submitted the therapy with trastuzumab in early and advanced stage of the disease. Review conducted in a university hospital and a private clinic, both located in Rio de Janeiro State, Brazil.Results: Cardiovascular events were late for trastuzumab, with predominance of moderate reactions. There was a predominance of dyspnea, increased blood pressure, fatigue and reduced left ventricular ejection.Conclusion: The results resemble similarities in the pattern of the institutions’ reactions. Identify possible AE and know the toxicity profile of trastuzumab can contribute to a safer therapy.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular adverse effects associated with the use of anti-HER2 in breast cancer treatment

Valente,

da Silva,

da Silva

et al. 2023

Front. Pharmacol.

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“…Conforme proposto por alguns autores, pacientes na vigência de tratamento com trastuzumabe deveriam passar por uma avaliação inicial para estratificação de fatores de risco e uma avaliação da FEVE 3,8 . Embora existam diferentes definições para o diagnóstico da disfunção ventricular associada ao tratamento do câncer, uma das definições mais utilizadas é a redução da FEVE abaixo de 53% ou redução de 10 % do valor basal, com ou sem sintomas, e repetindo o exame duas a três semanas depois 4 .…”

Section: Discussionunclassified

“…Embora já exista na literatura outros métodos preditores de cardiotoxicidade mais sensíveis, a avaliação regular pela FEVE, por meio do ECO, representa um método seguro, de fácil aplicabilidade e baixo custo, que pode auxiliar no monitoramento de pacientes em tratamento com medicamentos cardiotóxicos, como o trastuzumabe 8 .…”

Section: Discussionunclassified

A Importância do Monitoramento e da Identificação Precoce de Cardiotoxicidade do Tratamento com Trastuzumabe no Câncer de Mama: Relato de Caso

Valente

Souza

Braga

et al. 2019

Rev. Brasileira.De.Cancerologia

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Introdução: O câncer de mama representa a neoplasia mais frequente entre as mulheres, com elevada morbimortalidade. Com o advento de novos medicamentos, houve um aumento na sobrevida global; entretanto, o trastuzumabe, um anticorpo monoclonal utilizado no tratamento, pode promover cardiotoxicidade, que deve ser avaliada e monitorada durante o tratamento. O objetivo deste artigo é descrever um relato de caso de paciente que apresentou cardiotoxicidade associada ao uso de trastuzumabe e a importância do monitoramento e da identificação precoce da cardiotoxicidade por meio do monitoramento pelo ecocardiograma (ECO). Relato do caso: Paciente, sexo feminino, 63 anos, hipertensa, obesa, com câncer de mama, apresentou cardiotoxicidade associada ao uso de trastuzumabe, com redução da fração de ejeção do ventrículo esquerdo (FEVE) e desenvolveu diabetes após o tratamento. A paciente fez acompanhamento regular pelo ECO durante o tratamento, tendo sido esse processo fundamental para a detecção precoce e o manejo adequado da cardiotoxicidade associada ao uso do trastuzumabe. Foi utilizado um algoritmo na determinação da causalidade. Conclusão: Este estudo mostra a importância do acompanhamento da FEVE pelo ECO em pacientes submetidas à quimioterapia cardiotóxica, e do monitoramento de possíveis alterações metabólicas após o tratamento oncológico.

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“…Vascular changes may initially induce high blood pressure, thus adding further stress to the heart muscle. Over time, the combination of these mechanisms can induce morphological changes that are detectable through imaging as markers of injury and predictors of functional decline, if identified before the resting functions start to deteriorate (19)(20)(21). Additional risk factors for developing cardiotoxicity include preexisting heart disease and cardiovascular risk factors, including diabetes or obesity, old age and higher cumulative doses or more aggressive treatment regimens (22,23).…”

Section: Characteristics Of Cardiotoxicitymentioning

confidence: 99%

The role of stress echocardiography in identifying cardiotoxicity: an in-depth exploration

Wang,

Wang

2024

Front. Cardiovasc. Med.

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Cancer treatment might cause heart failure and deteriorate the patients’ quality of life. Despite the wide use of conventional echocardiography, it often fails to detect cardiotoxicity until advanced cardiac dysfunction at potentially irreversible stages. Advanced techniques, such as three-dimensional imaging and strain analysis in stress echocardiography, have shown promise in identifying cardiotoxicity at subclinical stages, even when traditional measures remain within normal ranges. These novel techniques have been shown to identify cardiac impairment in 30%–50% of the patients undergoing potentially cardiotoxic chemotherapy, which allows for early intervention and enhanced patient management. Although professional societies are advocating for the inclusion of these techniques into routine monitoring protocols, more research is needed to optimize and standardize their use across various centers and chemotherapeutic agents. This review explores the role of stress echocardiography in the early detection and monitoring of chemotherapy-induced cardiotoxicity. It delves into current knowledge and emerging research, aiming to provide a comprehensive understanding and to highlight areas worthy of further investigation.

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Early Detection and Monitoring of Cancer Chemotherapy-Related Left Ventricular Dysfunction by Imaging Methods

Cited by 5 publications

References 57 publications

Cardiovascular adverse effects associated with the use of anti-HER2 in breast cancer treatment

Cardiovascular adverse effects associated with the use of anti-HER2 in breast cancer treatment

A Importância do Monitoramento e da Identificação Precoce de Cardiotoxicidade do Tratamento com Trastuzumabe no Câncer de Mama: Relato de Caso

The role of stress echocardiography in identifying cardiotoxicity: an in-depth exploration

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