Anthracycline-Induced Cardiomyopathy

Abstract

In cancer patients developing AC-CMP, LVEF recovery and cardiac event reduction may be achieved when cardiac dysfunction is detected early and a modern HF treatment is promptly initiated.

Cardio-Oncology

“…HF and left ventricular (LV) dysfunction are the dreaded short and long-term complications of anthracyline exposure occurring in 5% to 23% of patients, causing diminished exercise capacity and progressive HF symptoms. 11,12 The risk for early and late anthracycline toxicity is largely a function of cumulative , there is a 5% risk of developing HF, which increases to 25% at 700 mg/m 2 . 13 In patients with additional risk factors, such as age at 2 extremes (age <18 and >65 years), prior cardiac pathology (hypertension, LV hypertrophy, coronary artery disease), diabetes mellitus, or prior radiation exposure, the recommended total cumulative exposure is decreased to 450 mg/m 2 to reduce the risk of LV dysfunction.…”

“…125 The European Society of Medical Oncology recommendations are based on several small studies demonstrating improvement in cardiac function with the initiation of neurohormonal antagonist in patients with chemotherapy-induced cardiomyopathy and the preservation of cardiac function from prophylactic use of ACE/BB therapy. 12,126 One of the critical factors in cardiac recovery from AIC is the prompt initiation of standard HF therapy. Cardinale et al demonstrated that the time elapsed from the end of chemotherapy to the start of HF therapy (time-to-treatment), with ACE and, when tolerated, with BB, is a crucial variable for recovery of cardiac dysfunction in patients treated with anthracyclines.…”

Prevention and Monitoring of Cardiovascular Complications in Patients With Luminal Her2-Negative Metastatic Breast Cancer

“…Важным фактом является то, что снижение ФВ ЛЖ -это позднее проявление кардиотоксичности. Лечебные стратегии не всегда могут быть действенными [21]. Поэтому важна ранняя диагностика субклинической дисфункции ЛЖ.…”

Cardiac Imaging: Multimodality Advances and Surveillance Strategies in Detection of Cardiotoxicity

“…There is data to suggest the potential irreversibility of LV dysfunction despite the discontinuation of the cardiotoxic agent, and the likelihood of recovery has been linked to early introduction of HF therapy. Therefore, there is growing interest in strategies in detecting early CTRCD [9]. Currently, the generally accepted method to monitor and detect LV systolic dysfunction during the administration of cardiotoxic agents is the serial measurement of LVEF.…”