Cardio-oncology: A Focus on Cardiotoxicity

Abstract

Cardio-oncology is a recently developed field in cardiology aimed at significantly reducing cardiovascular morbidity and mortality and improving quality of life in cancer survivors. Cancer survival rates have been constantly increasing, mainly because of the advent of new, more potent and targeted therapies. However, many of the new therapies – along with some of the older chemotherapeutic regimens such as anthracyclines – are potentially cardiotoxic, which is reflected increasingly frequently in the published literature. Cardiotoxicity adversely affects prognosis in cancer patients, thus its prevention and treatment are crucial to improve quality and standards of care. This review aims to explore the existing literature relating to chemotherapy- and radiotherapy-induced cardiotoxicity. An overview of the imaging modalities for the identification of cardiotoxicity and therapies for its prevention and management is also provided.

The Utility of Intraventricular Pressure Gradient for Early Detection of Chemotherapy-Induced Subclinical Cardiac Dysfunction in Dogs

“…Side effects of chemotherapy are an endless challenge that has attracted comparative oncologists to use dogs as models to evaluate the pros and cons of therapeutic strategies [ 28 , 29 ]. Cardiotoxicity is a common drawback of the DXR and subsequently leads to cardiomyopathy in cumulative dosing in dogs [ 2 ].…”

Dietary Supplementation with Anti-Inflammatory Omega-3 Fatty Acids for Cardiovascular Protection: Help or Hoax?

“…Large doses (4 g daily) of pharmaceutical preparations of omega-3 fatty acids, however, represent an effective therapy for reducing both blood triglyceride levels and improving cardiovascular outcomes in patients with hypertriglyceridemia despite the use of statins. Future studies should focus on using high doses of omega-3 fatty acids, particularly those preparations with improvedpharmacokinetic propertiesin the intervention of cardiovascular disorders, including drug-induced cardiotoxicity, an increasingly important issue in clinical oncology [29] (Figure 3).…”

Preventive Cardio-Oncology: The Time Has Come

“…It is interesting to consider who should be responsible for CV screening, monitoring, and treatment in Preventive Cardio-Oncology, in the short-term and long-term, before, during, and after cancer therapies. There are several excellent algorithms in literature to guide the flow of patient care in Cardio-Oncology (3,11,14,17,18,(155)(156)(157)(158). Most of these algorithms focus on the relationships among the cardiologist, oncologist, hematologist, and patient, or on steps to follow regarding surveillance for or management of left ventricular dysfunction or other cardiovascular toxicities, or monitoring recommendations for patients being treated with particular cancer therapies.…”