Rationale and Design of the Strain Surveillance of Chemotherapy for Improving Cardiovascular Outcomes

Negishi, Tomoko; Thavendiranathan, Paaladinesh; Negishi, Kazuaki; Marwick, Thomas H.; Aakhus, Svend; Murbræch, Klaus; Massey, Richard J.; Bansal, Manish; Fukuda, Nobuaki; Hristova, Krassimira R.; Izumo, Masaki; Gerche, André La; Costello, Ben; Lemieux, Julie; Côté, Mélissa; Deblois, Jonathan; Mottram, P.; Miyazaki, Sakiko; Nolan, Mark; Pěnička, Martin; Ondrúš, Tomáš; Stefanidis, E; Seldrum, Stéphanie; Shirazi, Mitra; Shkolnik, Evgeny; Amir, Eitan; Thampinathan, Babitha; Thomas, Liza; Yamada, Hirotsugu; Vinereanu, Dragoş; Popescu, Bogdan A.; Mihalcea, Diana; Călin, Andreea; Cho, Goo Yeong; Kurosawa, Koji; Galderisi, Maurizio; Santoro, Ciro

doi:10.1016/j.jcmg.2018.03.019

Cited by 131 publications

(68 citation statements)

References 40 publications

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“…The 2016 European Society of Cardiology position paper recommends GLS, when available and performed with adequate expertise, to inform clinical decisions . An ongoing, multicenter, randomized controlled trial will provide evidence regarding the place of GLS for surveillance during chemotherapy and the impact of strain‐guided cardioprotective therapy on mitigating LVEF reduction in patients at risk of cardiotoxicity during cancer therapy .…”

Section: Resultsmentioning

confidence: 99%

Prevention, Monitoring, and Management of Cardiac Dysfunction in Patients with Metastatic Breast Cancer

et al. 2019

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Cardiac monitoring is becoming an important part of breast cancer care. Breast cancer and cardiovascular disease (CVD) share many common risk factors, and it is estimated that by the median age of diagnosis, many patients with breast cancer will have established or subclinical CVD. In addition, a number of treatments for metastatic breast cancer are known to have cardiac effects. As such, there is a clear need to prevent, identify, and effectively manage cardiovascular events in patients with breast cancer. Current clinical practice for patients with metastatic breast cancer involves a comprehensive set of assessments to ensure efficacy and safety of treatment. Adding cardiac monitoring to the assessments already required for patients with breast cancer may improve survival and quality of life. Currently, cardiac monitoring is recommended for several breast cancer treatments, and guidelines related to cardiac monitoring are available. Here, we review the risk of CVD in patients with breast cancer, providing an overview of the cardiac events associated with standard therapies for metastatic breast cancer. We also assess the current clinical recommendations relating to cardiac monitoring, and practical management strategies for oncologists. Cardio‐oncology is a growing medical subspecialty that promotes the need for effective cancer therapy while minimizing cardiac effects. Integrating cardiac monitoring into routine clinical practice may safeguard patients with metastatic breast cancer against adverse cardiac effects. Implications for Practice This review details the common risk factors associated with cardiovascular disease that are frequently observed in patients with metastatic breast cancer, as well as the adverse cardiac effects of many therapies that are commonly prescribed. The review also provides a rationale for routine and comprehensive cardiovascular assessment of all patients at baseline, and during and after therapy depending on the treatment and presence of risk factors for cardiovascular disease. The medical discipline of cardio‐oncology is increasingly being recognized as an important part of clinical practice to ensure effective cancer therapy while maintaining cardiac health.

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Section: Resultsmentioning

confidence: 99%

Prevention, Monitoring, and Management of Cardiac Dysfunction in Patients with Metastatic Breast Cancer

et al. 2019

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“…The recent ASE/EACVI consensus defined a relative decrease in GLS of >15% from baseline as an indicator of subclinical LV dysfunction and appropriate use criteria for multi-modality imaging include strain for the evaluation of patient candidates for chemotherapy (19,70). Finally, the SUCCOUR trial (first randomized controlled trial of GLS-guided therapy introduction) will better define the role of GLS for surveillance for chemotherapy-related cardiac dysfunction (71).…”

Section: Tissue Doppler and Strain Echocardiographymentioning

confidence: 99%

Cardiotoxicity of Anthracyclines

Cardinale

Fabiani

Cipolla

2020

Front. Cardiovasc. Med.

279

214

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Cardiotoxicity is a feared side effect that may limit the clinical use of anthracyclines. It may indeed affect the quality of life and survival of patients with cancer, regardless of oncological prognosis. This paper provides an overview of anthracycline-induced cardiotoxicity in terms of definition, classification, incidence, risk factors, possible mechanisms, diagnosis, and treatment. We also report effective strategies for preventing cardiotoxicity. In addition, we discuss limiting current approaches, the need for a new classification, and early cardiotoxicity detection and treatment. Probably, anthracycline-induced cardiotoxicity is a continuous phenomenon that starts from myocardial cell injury; it is followed by left ventricular ejection fraction (LVEF) and, if not diagnosed and cured early, progressively leads to symptomatic heart failure. Anthracycline-induced cardiotoxicity can be detected at a preclinical phase. The role of biomarkers, in particular troponins, in identifying subclinical cardiotoxicity and its therapy with angiotensin-converting enzyme inhibitors (mainly enalapril) to prevent LVEF reduction is a recognized and effective strategy. If cardiac dysfunction has already occurred, partial or complete LVEF recovery may still be obtained in case of early detection of cardiotoxicity and prompt heart failure treatment.

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“…Negishi and colleagues state the important caveat that, although a dose-dependent association between anthracyclines and cardiotoxicity has been established, no safety threshold exists. Currently underway, the prospective, international, multicentre randomised controlled trial, Strain sUrveillance during Chemotherapy for improving Cardiovascular Outcomes (SUCCOUR) Study, is testing the hypotheses that information from echocardiographic strain imaging leads to the use of adjunctive cardioprotective therapy that will limit, i) the development of LV dysfunction, ii) interruptions of planned chemotherapy and iii) the development of heart failure during follow-up [23].…”

mentioning

confidence: 99%

Echocardiography: Navigating Complexities to Provide Many Useful Applications in Contemporary Clinical Cardiology

Gregory

Stanton

Thomas

et al. 2019

Heart, Lung and Circulation

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Echocardiography has been around for more than half a century [1]. Recent decades have seen significant technological advances, with increasing clinical applications of this non-invasive imaging tool, beyond the basic assessment of left ventricular function, with further evolution evident on the horizon. There has also been a burgeoning increase in use: According to the 2017 Australian Medicare Medical Benefits Schedule (MBS) Taskforce, about 900,000 echocardiographic procedures (excluding stress echo) are reimbursed annually, at a cost of over $180 million each year [2]. In addition, the use of echo is growing at a rate of about 8.8% each year [3]. Stress echocardiography accounts for over $56 million in billing annually in Australia and has grown each year at a rate of 12% for the past 5 years [4]. In recognition of this expanding use, this fully commissioned Special Issue of Heart, Lung and Circulation presents an overview of contemporary practice in echocardiography.

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Rationale and Design of the Strain Surveillance of Chemotherapy for Improving Cardiovascular Outcomes

Cited by 131 publications

References 40 publications

Prevention, Monitoring, and Management of Cardiac Dysfunction in Patients with Metastatic Breast Cancer

Prevention, Monitoring, and Management of Cardiac Dysfunction in Patients with Metastatic Breast Cancer

Cardiotoxicity of Anthracyclines

Echocardiography: Navigating Complexities to Provide Many Useful Applications in Contemporary Clinical Cardiology

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