MRI in cardio‐oncology: A review of cardiac complications in oncologic care

Jeong, Daniel; Gladish, Gregory W.; Chițiboi, Teodora; Fradley, Michael G.; Gage, Kenneth L.; Schiebler, Mark L.

doi:10.1002/jmri.26895

Cited by 18 publications

(11 citation statements)

References 104 publications

(311 reference statements)

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“…In this case series, we investigate the role of early S/V use in chemotherapy-induced cardiomyopathy, coupled with the use of WCD as a bridging therapy while waiting for ventricular function recovery. The CMR played a major role in confirming the echocardiographic data, in ruling out the ischemic etiology, ( 11 ) and in better defining the cardiac damage ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Its role in tissue characterization can help eliminate other possible causes of myocardial dysfunction when cardiac toxicity is suspected. For this purpose, T1 and T2 mapping, in addition to late gadolinium enhancement (LGE), are very useful tools ( 10 ). We collected a case series of four patients with acute heart failure and deeply depressed EF secondary to anthracyclines or carfilzomib cardiotoxicity.…”

Section: Introductionmentioning

confidence: 99%

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Case Series: Recovery of Chemotherapy-Related Acute Heart Failure by the Combined Use of Sacubitril Valsartan and Wearable Cardioverter Defibrillator: A Novel Winning Combination in Cardio-Oncology

Canale

Coviello

Solarino

et al. 2022

Front. Cardiovasc. Med.

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Effective anticancer treatments have dramatically improved the outcome of patients with cancer, but cardiac toxicity reduces their clinical efficacy in a non-negligible percentage of patients. Sacubitril/valsartan is a new paradigm in the treatment of chronic heart failure, with a reduced ejection fraction due to the enhancement of natriuretic peptides' properties when coupled with a blocking effect on the angiotensin II type 1 (AT1) receptors. As with other clinical conditions of heart failure with potentially reversible declines in cardiac function, a wearable cardioverter defibrillator (WCD) is a valid tool for protection against sudden death until recovery occurs. We report a case series of four patients with chemotherapy-related acute cardiac failure with severely reduced cardiac function. They were successfully treated with sacubitril/valsartan while being protected from malignant arrhythmias using a wearable cardioverter defibrillator until the recovery of cardiac function. Sacubitril/valsartan was confirmed to be effective in anthracycline-related cardiac toxicity and the wearable cardioverter defibrillator should be considered as a support tool even in the oncology patient.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case Series: Recovery of Chemotherapy-Related Acute Heart Failure by the Combined Use of Sacubitril Valsartan and Wearable Cardioverter Defibrillator: A Novel Winning Combination in Cardio-Oncology

Canale

Coviello

Solarino

et al. 2022

Front. Cardiovasc. Med.

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“…Cardiac magnetic resonance (CMR) allows a characterisation of myocardial tissue changes such as intracellular and interstitial oedema and fibrosis, which may represent early markers of myocardial injury [ 102 ]. T1- and T2-weighted imaging and T2 and T1 mapping sequences can help identify intracellular and interstitial oedema [ 103 , 104 ].…”

Section: Evidence Of Cardiac Disease In Cancer Patientsmentioning

confidence: 99%

Subclinical cardiac damage in cancer patients before chemotherapy

et al. 2021

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Cancer and cardiovascular diseases, including heart failure (HF), are the main causes of death in Western countries. Several anticancer drugs and radiotherapy have adverse effects on the cardiovascular system, promoting left ventricular dysfunction and ultimately HF. Nonetheless, the relationship between cancer and HF is likely not unidirectional. Indeed, cancer and HF share common risk factors, and both have a bidirectional relationship with systemic inflammation, metabolic disturbances, and neurohormonal and immune activation. Few studies have assessed the impact of untreated cancer on the heart. The presence of an active cancer has been associated with elevated cardiac biomarkers, an initial impairment of left ventricular structure and function, autonomic dysfunction, and reduced exercise tolerance. In turn, these conditions might increase the risk of cardiac damage from chemotherapy and radiotherapy. HF drugs such as beta-blockers or inhibitors of the renin–angiotensin–aldosterone system might exert a protective effect on the heart even before the start of cancer therapies. In this review, we recapitulate the evidence of cardiac involvement in cancer patients naïve from chemotherapy and radiotherapy and no history of cardiac disease. We also focus on the perspectives for an early diagnosis and treatment to prevent the progression to cardiac dysfunction and clinical HF, and the potential benefits of cardioactive drugs on cancer progression.

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“…Profound RACVD may show a reduction of LV ejection fraction, and subclinical disease may reveal early signs of decreased global longitudinal strain (107)(108)(109). Recently, other advanced imaging modalities are attractive for detecting RACVD (110), such as cardiac computed tomography (111)(112)(113) and cardiovascular magnetic resonance (CMR) (114)(115)(116).…”

Section: Challenges Of Clinical Detection For Racvdmentioning

confidence: 99%

Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care

Lee

Liu

Hung

et al. 2020

Front. Cardiovasc. Med.

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Radiotherapy (RT) is a crucial treatment modality in managing cancer patients. However, irradiation dose sprinkling to tumor-adjacent normal tissues is unavoidable, generating treatment toxicities, such as radiation-associated cardiovascular dysfunction (RACVD), particularly for those patients with combined therapies or pre-existing adverse features/comorbidities. Radiation oncologists implement several efforts to decrease heart dose for reducing the risk of RACVD. Even applying the deep-inspiration breath-hold (DIBH) technique, the risk of RACVD is though reduced but still substantial. Besides, available clinical methods are limited for early detecting and managing RACVD. The present study reviewed emerging challenges of RACVD in modern radiation oncology, in terms of clinical practice, bench investigation, and multidisciplinary care. Several molecules are potential for serving as biomarkers and therapeutic targets. Of these, miRNAs, endogenous small non-coding RNAs that function in regulating gene expression, are of particular interest because low-dose irradiation, i.e., 200 mGy (one-tenth of conventional RT daily dose) induces early changes of pro-RACVD miRNA expression. Moreover, several miRNAs, e.g., miR-15b and miR21, involve in the development of RACVD, further demonstrating the potential bio-application in RACVD. Remarkably, many RACVDs are late RT sequelae, characterizing highly irreversible and progressively worse. Thus, multidisciplinary care from oncologists and cardiologists is crucial. Combined managements with commodities control (such as hypertension, hypercholesterolemia, and diabetes), smoking cessation, and close monitoring are recommended. Some agents show abilities for preventing and managing RACVD, such as statins and angiotensin-converting enzyme inhibitors (ACEIs); however, their real roles should be confirmed by further prospective trials.

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MRI in cardio‐oncology: A review of cardiac complications in oncologic care

Cited by 18 publications

References 104 publications

Case Series: Recovery of Chemotherapy-Related Acute Heart Failure by the Combined Use of Sacubitril Valsartan and Wearable Cardioverter Defibrillator: A Novel Winning Combination in Cardio-Oncology

Case Series: Recovery of Chemotherapy-Related Acute Heart Failure by the Combined Use of Sacubitril Valsartan and Wearable Cardioverter Defibrillator: A Novel Winning Combination in Cardio-Oncology

Subclinical cardiac damage in cancer patients before chemotherapy

Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care

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