Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Lipshultz, Steven E.; Adams, M. Jacob; Colan, Steven D.; Constine, Louis S.; Herman, Eugene H.; Hsu, Daphne T.; Hudson, Melissa M.; Kremer, Leontien C. M.; Landy, David C.; Miller, Tracie L.; Oeffinger, Kevin C.; Rosenthal, David N.; Sable, Craig; Sallan, Stephen E.; Singh, Gautam K.; Steinberger, Julia; Cochran, Thomas R.; Wilkinson, James D.

doi:10.1161/cir.0b013e3182a88099

Cited by 494 publications

(480 citation statements)

References 687 publications

(811 reference statements)

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“…The close surveillance by echocardiographic studies ensuing from the treatment protocols among affected patients [30] may lead to a detection bias of even mild cardiac anomalies and early detection of acquired disease [30]. The effect of chemotherapy, and specifically anthracyclines, is known for its cardiac toxicity, although causing valvar or myocardial abnormalities rather than structural ones.…”

Section: Discussionmentioning

confidence: 99%

Cardiac anomalies and associated comorbidities in a large adolescent population

Fink

Machluf

Farkash

et al. 2017

International Journal of Adolescent Medicine and Health

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Abstract:Objective: To determine the prevalence, secular trends and associations of heart disease in a large unscreened, otherwise basically healthy, adolescent population. Subjects and methods: Cross-sectional study of the cardiac status of 113,694 adolescents from the northern district of Israel, who completed the profiling process between the ages of 16 and 19, including all essential measures over a 22-year period. Results of imaging were categorized as either isolated valvar or structural abnormalities, and their clinically significant subgroups defined prospectively. The findings were correlated with the socio-demographic and anthropometric data and non-cardiac health conditions. Results: Of those sent for echocardiography, 1257 (0.93% of the total population) had isolated valvar disease and 216 (0.19%) had structural abnormalities, with 20% of both groups considered significant. Females had lower prevalence of heart disease. There was peak prevalence in the second 5-year period. Tall subjects or a past history of rheumatic fever had more valvar abnormalities. Thin subjects or those with skeletal anomalies had more structural abnormalities. Significant valvar and structural anomalies were more common in subjects with learning disorders, endocrine disorders and diabetes mellitus. Fewer valvar abnormalities were diagnosed in obese subjects. Heart disease was more common in those with non-solid tumors. Conclusion: Appreciable numbers of potentially healthy adolescents were found to have heart disease. There appeared to be an association with body size, skeletal abnormalities and relatively common medical disorders, the cause of which remains to be determined in prospective studies that could change the way common adolescent disease should be followed.

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Section: Discussionmentioning

confidence: 99%

Cardiac anomalies and associated comorbidities in a large adolescent population

Fink

Machluf

Farkash

et al. 2017

International Journal of Adolescent Medicine and Health

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“…An important goal in the field of cardio-oncology is to discover or develop a highly sensitive diagnostic test to accurately detect the subclinical changes of cardiac injury before there is overt clinical manifestation. 13 Load-independent measures of left ventricular systolic function, such as measures of cardiac strain and strain rate and tissue Doppler imaging of systolic and diastolic function are showing some promise in the early detection of cardiotoxicity. [14][15][16][17] In addition, serum biomarkers, particularly high-sensitivity cardiac troponins and NTproBNP, may be useful in predicting the development of cardiac dysfunction.…”

Section: See Related Article Pp 256-264mentioning

confidence: 99%

Anthracycline-induced cardiomyopathy: The search continues

Kim

Bergmann

2017

Journal of Nuclear Cardiology

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“…6 Ng AK and Lipshultz et al both reported that the mechanism of cardiovascular injury in their group of patients is multifactorial. 7,8 Endothelial injury of the coronary vessels, the production of several inflammatory and profibrotic cytokines have an important role in the appearance and progression of this disease. Daniëls et al described unpredicted premature deaths from myocardial infarction at early ages following Hodgkin lymphoma and underline the necessity of cardiovascular screening of HL survivors.…”

mentioning

confidence: 99%

“…Kupeli et al and Lipshultz et al recommend coronary CT and coronary calcium scoring as screening methods for coronary artery disease and conventional echocardiography and tissue Doppler imaging for valvular heart disease in patients after or under chemo-and radiotherapy. 8,11 Groacher et al created an algorithm for screening patients with non-Hodgkin lymphoma (NHL), who received mediastinal/thoracic radiotherapy. 13 In patients with signs/symptoms of constrictive pericarditis transthoracic echocardiography (TTE) ± CT or magnetic resonance imaging (MRI) is recommended.…”

mentioning

confidence: 99%

Noninvasive Assessment of Coronary Arteries in Patients with Hematologic Disorders

Lázár¹,

Oltean²,

Jáni³

et al. 2017

Journal of Interdisciplinary Medicine

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Hematological conditions and their treatments have an increased risk of cardiovascular events, and invasive interventions have a higher risk of periprocedural complications in this group of patients. The aim of this review was to evaluate the risk of invasive interventions in patients with hematologic disorders and to underline the role of noninvasive cardiovascular screening in patients with hematological disorders such as Hodgkin and non-Hodgkin lymphoma, anemia, hemophilia, thrombocythemia, polycythemia vera, and leukemia. Based on present knowledge in the field, our opinion is that the screening of patients with hematological diseases is very important to reduce the morbidity and mortality due to cardiovascular events. Noninvasive assessments are suitable for this purpose with a significantly lower risk compared to invasive interventions.

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Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Cited by 494 publications

References 687 publications

Cardiac anomalies and associated comorbidities in a large adolescent population

Cardiac anomalies and associated comorbidities in a large adolescent population

Anthracycline-induced cardiomyopathy: The search continues

Noninvasive Assessment of Coronary Arteries in Patients with Hematologic Disorders

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