Role of cardioprotective therapy for prevention of cardiotoxicity with chemotherapy: A systematic review and meta-analysis

Kalam, Kashif; Marwick, Thomas H.

doi:10.1016/j.ejca.2013.04.030

Cited by 290 publications

(213 citation statements)

References 56 publications

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“…A recent meta-analysis of a small number of trials showed a relative risk reduction in risk of heart failure or LVEF decline following chemotherapy of approximately 70% for b-blockers and 90% for ACEinhibitors. 8 These data support the concept that optimization of hemodynamics and neurohormonal milieu prior to anthracycline therapy may help to prevent myocyte injury. Another promising strategy for the management of LV dysfunction due to anticancer treatment relies on the use of novel, more sensitive diagnostic techniques allowing earlier recognition of myocardial damage.…”

Section: Chemotherapy-induced Cardiomyopathysupporting

confidence: 71%

Reversible Dilated Cardiomyopathy: Into the Thaumaturgy of the Heart - Part 2

et al. 2016

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Dilated cardiomyopathy (DCM) is a genetic or acquired heart muscle disorder characterized by dilation and impaired contraction of one or both ventricles. In the acquired forms of the disease, if the pathogenic agent is persistent, undiagnosed or untreated, permanent ultrastructural and morphological changes may lead to irreversible dysfunction. Conversely, when DCM is promptly recognized and treated, the heart may show an extraordinary ability to recover from left ventricular (LV) systolic dysfunction. While much research in heart failure has focused on morbidity and mortality associated with persistent LV systolic dysfunction, relatively little attention has been devoted to this remarkable potential for recovery. In this two-part review we will focus on the most common types of reversible DCM. The second part will deal with chemotherapy-induced cardiomyopathy, alcohol-related cardiomyopathy, myocarditis and peripartum cardiomyopathy. Although diverse in etiopathogenesis, genetic background, therapeutic options and outcome, the forms of DCM characterized by reversible LV dysfunction share similar challenges in diagnosis and clinical management. The identification of pathways to recovery may show the way for novel therapeutic targets ultimately benefitting all cardiac patients.

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Section: Chemotherapy-induced Cardiomyopathysupporting

confidence: 71%

Reversible Dilated Cardiomyopathy: Into the Thaumaturgy of the Heart - Part 2

et al. 2016

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“…In spite of this, a recent meta-analysis did not find statistical heterogeneity between study results and concluded that prophylactic treatment with angiotensin antagonists or β-blockers prevents HF or LVEF decline in patients treated with chemotherapy. 80 In all of the studies, the cardioprotective effect clearly depended on the basal risk (Figure 2), emphasizing the importance of basal risk stratification to better select patients to be submitted to pharmacological cardioprevention. Large, randomized, multicenter studies performed in patients treated with and without novel therapies are clearly needed to confirm these results.…”

Section: Administration Of Cardioprotective Drugsmentioning

confidence: 99%

Myocardial Protection During Cardiotoxic Chemotherapy

Witteles

Bosch

2015

Circulation

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“…iron chelators, angiotensin-converting enzyme inhibitors, b-blockers, or statins) may be helpful in reducing the risk for cardiotoxicity. 189 The most effective agents appear to be dexrazoxane 190,191 and statin therapy. 192,193 The use of vasoactive medications may be limited by the risk for side effects (especially dizziness and hypotension) 194 and is supported by limited evidence for angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and b-blockers.…”

Section: Implications Of Early Detection On Therapeutic Approachesmentioning

confidence: 99%