Cardio-oncology Clinical Assessment and Screening in Patients Undergoing High Toxicity Chemotherapy: A Retrospective Cohort Study

Abstract

Objective: To describe the clinical characteristics and cardio-oncological assessment in patients undertaking highly toxic chemotherapy and/or chest radiotherapy in a high-complexity hospital.Methods: A single-center retrospective cohort study was carried out between January 1st, 2017 and December 31st, 2019. The medical records of patients with solid or hematological neoplasms were reviewed. Descriptive information was obtained on demographic characteristics, chemotherapeutic agents, prechemotherapy cardiovascular (CV) evaluation, and CV outcomes. The risk of complications was assessed using the Mayo Clinic risk score.Results: A total of 499 patients were included, the most common neoplasm was non-Hodgkin's lymphoma (21.6%), followed by breast cancer (19.4%). A very high risk of cardiotoxicity was present in 44.1% and 90% were not evaluated by cardiology. Pre-chemotherapy echocardiography was obtained in 65%, but only 19.4% underwent echocardiographic control after finishing chemotherapy. The most frequent CV outcomes were chemotherapy-related systolic dysfunction (4.4%) and rhythm disturbances (2.8%), with atrial fibrillation and atrial flutter being the most frequent arrhythmias.Conclusion: Despite the recognized CV toxicity of chemotherapeutic drugs, the majority of patients receiving highly toxic regimens at high risk of CV complications are not previously evaluated by a cardiologist and the CV workup was not routinely used in our study. The implementation of cardio-oncology programs will facilitate the identification of high-risk patients, aiming to detect and treat complications early.

Artificial intelligence-assisted evaluation of cardiac function by oncology staff in chemotherapy patients

“…Real-world data from a recent retrospective cohort study showed that pre-chemotherapy echocardiography was obtained in 65% of patients, but only in 19% of them after completing chemotherapy. 33 Consequently, the feasibility of accurate and reproducible calculation of LVEF by oncology staff at the point of care shown in this study can have significant clinical implications. By using robust guiding and measurement AI algorithms, it could be applied as an initial screening tool pre- and post-chemotherapy for timely detection of cardiac dysfunction when SE examination is not readily available; this strategy could potentially expedite clinical care for cancer patients in case of impaired LVEF detection and speed up referral to a cardio-oncology clinic, where a more thorough cardiac evaluation beyond the mere LVEF measurement can be performed.…”

Cardiotoxicity in Cancer Patients: The Prevalence, Risk Factors, and Cardioprotective Measures in a Cancer Centre in Saudi Arabia

“…Chemotherapy-related cardiotoxicity gained significant emphasis as it has been linked to the risk of cardiac dysfunction, thromboembolic events, and arrhythmias, necessitating the implementation of effective prevention and treatment strategies [ 1 ]. Notably, cardiotoxicity has become more noticeable with the advancement of cancer screening and detection, along with the improvement of chemotherapeutic efficacy and overall prolonged survival [ 2 ].…”