Abstract:AimsAs the world population grows older, the co-existence of cancer and cardiovascular comorbidities becomes more common, complicating management of these patients. Here, we describe the impact of a large Cardio-Oncology unit in Southern Italy, characterizing different types of patients and discussing challenges in therapeutic management of cardiovascular complications.
Methods and resultsWe enrolled 231 consecutive patients referred to our Cardio-Oncology unit from January 2015 to February 2020. Three differe… Show more
“…The contributions of the new cardio‐specific biomarkers in serum and of modern imaging techniques (global longitudinal strain and three‐dimensional left ventricular ejection fraction) and genotyping, and especially their combined use in risk prediction are presented. The benefit of a cardio‐oncology unit on prevention of cardiovascular events in cancer patients is discussed 7 …”
Section: Risk Factors and Preventionmentioning
confidence: 99%
“…The benefit of a cardio-oncology unit on prevention of cardiovascular events in cancer patients is discussed. 7 An effective fluid management programme is associated with improving readmission and mortality in HF according to a systemic review. 8 The results encourage attainment of optimal volume status at discharge and prescription of optimal diuretic dose.…”
We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF‐related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio‐oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state‐of‐the‐art molecular biologic methods, multi‐omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022.
“…The contributions of the new cardio‐specific biomarkers in serum and of modern imaging techniques (global longitudinal strain and three‐dimensional left ventricular ejection fraction) and genotyping, and especially their combined use in risk prediction are presented. The benefit of a cardio‐oncology unit on prevention of cardiovascular events in cancer patients is discussed 7 …”
Section: Risk Factors and Preventionmentioning
confidence: 99%
“…The benefit of a cardio-oncology unit on prevention of cardiovascular events in cancer patients is discussed. 7 An effective fluid management programme is associated with improving readmission and mortality in HF according to a systemic review. 8 The results encourage attainment of optimal volume status at discharge and prescription of optimal diuretic dose.…”
We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF‐related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio‐oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state‐of‐the‐art molecular biologic methods, multi‐omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022.
“…As a “universal” strategy of cardioprotection for all patients is so unfeasible, a careful triage is needed to deliver cardioprotective treatment only to high-risk patients ( 69 ) as indicated also by guidelines ( 29 ). Cardioprotective pharmacological treatment of CSs must aggressively address pre-existing CVRFs and cancer-therapy-induced derangements in cardiometabolic pathways and should be combined with non-pharmacological interventions ( 70 ). The intersection of poor adherence to the cardiac medications necessitated by cancer treatment, chemotherapy-induced metabolic derangements (e.g., weight gain) ( 71 ) and cancer-treatment-induced reductions in cardiorespiratory reserve exemplify the dangerous combination of “hits” that may translate into a clinical cardiac event ( 35 ).…”
Section: Lowering the Cardiovascular Risk In Cancer Survivorsmentioning
In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The ultimate goal is a personalized care of CS, achievable only through a multidisciplinary-guided survivorship care plan, one that replaces the fragmented management of current healthcare systems. Collaboration between oncologists and cardiologists is the pillar of a framework in which primary care providers and other specialists must be engaged and in which familial, social and environmental factors are also taken into account.
“…Unfortunately, the availability and structure of current cardio-oncology services remain globally diverse [ 71 , 72 ], which can be attributed to limited organizational structures and competence of professionals to manage cardiovascular issues that arise in cancer patients. This can ultimately lead to poorer health outcomes for patients [ 73 – 75 ]. Fig.…”
Section: Contribution Of Cardio-oncology Servicesmentioning
Cancer and cardiovascular disease are two of the leading causes of global mortality and morbidity. Medical research has generated powerful lifesaving treatments for patients with cancer; however, such treatments may sometimes be at the expense of the patient’s myocardium, leading to heart failure. Anti-cancer drugs, including anthracyclines, can result in deleterious cardiac effects, significantly impacting patients’ functional capacity, mental well-being, and quality of life. Recognizing this, recent international guidelines and expert papers published recommendations on risk stratification and care delivery, including that of cardio-oncology services. This review will summarize key evidence with a focus on anthracycline therapy, providing clinical guidance for the non-oncology professional caring for a patient with cancer and heart failure.
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