scholarly journals Heart failure from cancer therapy: can we prevent it?

2019 ◽  
Vol 6 (4) ◽  
pp. 856-862 ◽  
Author(s):  
Matthias Totzeck ◽  
Raluca I. Mincu ◽  
Gerd Heusch ◽  
Tienush Rassaf
Keyword(s):  
Heart Failure ◽  
Cancer Therapy

Very early detection of low dose anti-cancer therapy-related cardiotoxicity in lymphoma patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y.W Liu ◽  
H.Y Chang ◽  
C.H Lee ◽  
W.C Tsai ◽  
P.Y Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Cardiac Dysfunction ◽  
Systolic Dysfunction ◽  
Multivariable Analysis ◽  
Cardiopulmonary Exercise Test ◽  
Left Ventricular ◽  
Funding Source ◽  
Anti Cancer ◽  
All Cause Mortality

Abstract Background and purpose Left ventricular (LV) global peak systolic longitudinal strain (GLS) by speckle-tracking echocardiography is a sensitive modality for the detection of subclinical LV systolic dysfunction and a powerful prognostic predictor. However, the clinical implication of LV GLS in lymphoma patients receiving anti-cancer therapy remains unknown. Methods We prospectively enrolled 74 patients (57.9±17.0 years old, 57% male) with lymphoma who underwent echocardiography prior to chemotherapy, post 3rd and 6th cycle and 1 year after chemotherapy. Cancer therapy-related cardiac dysfunction (CTRCD) is defined as the reduction of absolute GLS value from baseline of ≥15%. All the eligible patients underwent a cardiopulmonary exercise test (CPET) upon completion of 3 cycles of anti-cancer therapy. The primary outcome was defined as a composite of all-cause mortality and heart failure events. Results Among 36 (49%) patients with CTRCD, LV GLS was significantly decreased after the 3rd cycle of chemotherapy (20.1±2.6% vs. 17.5±2.3%, p<0.001). In the multivariable analysis, male sex and anemia (hemoglobin <11 g/dL) were found to be independent risk factors of CTRCD. Objectively, patients with CTRCD had lower minute oxygen consumption/kg (VO2/kg) and lower VO2/kg value at anaerobic threshold in the CPET. The incidence of the primary composite outcome was higher in the CTRCD group than in the non-CTRCD group (hazard ratio 3.21; 95% CI, 1.04–9.97; p=0.03). Conclusion LV GLS is capable of detecting early cardiac dysfunction in lymphoma patients receiving anti-cancer therapy. Patients with CTRCD not only had a reduced exercise capacity but also a higher risk of all-cause mortality and heart failure events. Change of LVEF and GLS after cancer Tx Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Ministry of Science and Technology (MOST), Taiwan

scholarly journals Low-dose Erythropoietin reduces risk of heart failure induced by anti-cancer therapy

Oncotarget ◽  
2011 ◽  
Vol 2 (11) ◽  
pp. 825-825 ◽  
Author(s):  
Melanie Hoch ◽  
Denise Hilfiker-Kleiner
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Low Dose ◽  
Anti Cancer

P687Is sacubitril/valsartan useful in patients with cancer and heart failure? Data from HF-COH Spanish multicenter registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Martin Garcia ◽  
C Mitroi ◽  
M Chaparro ◽  
P Moliner ◽  
A Martinez-Monzonis ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Ejection Fraction ◽  
Arterial Pressure ◽  
Creatinine Clearance ◽  
Serum Levels ◽  
Left Ventricular ◽  
Functional Class ◽  
Multicenter Registry

Abstract Current guidelines recommend sacubitril/valsartan (S/V) for patients (p.) with heart failure and reduced left ventricular ejection fraction (LVEF) but there is lack of evidence of its efficacy and safety in p. with cancer and heart failure. Our aim was to analyze the potential benefit of S/V in specific cardio-oncology clinics. Methods We performed a retrospective multicenter registry (HF-COH) in six Spanish hospitals with cardio-oncology clinics including all p. treated with S/V. Clinical and echocardiographic data, NYHA functional class, type of neoplasms and anti-tumoral treatment were described. Median follow-up was 7.2 [7.9] months. Results Sixty-one p. were included (median age was 64 [21] years old; 64%women, 43% hypertensive, 54% dyslipidemics and 28% diabetics). Most of p. (97%) had cancer therapy related cardiac dysfunction (CTRD) with a median time from anti-cancer therapy to CTRD of 40 [132] months. Breast (46%) and hematological (38%) cancers were the most frequent neoplasms, 31% of p. had metastatic disease and 71% had been treated with anthracyclines. In 5% S/V was initiated at CTRCD diagnosis while in 95% S/V was started to improve clinical status in p. already treated with ACE inhibitors or ARBs. 87% were on beta-blocker therapy and 74% on mineralocorticoid receptor antagonists.Maximal S/V titration dose was achieved in 8.2% of p. (24/26mg: 43%; 49/51mg: 33%) S/V was discontinued in 4 p. (reasons: 2 hypotension; 1: renal failure; 1: pruritus) Baseline NT-proBNP levels, functional class, and LVEF improved at the end of follow-up in p. who continued with S/V (all p values ≤0.01). No statistical differences were found in creatinine clearance or potassium serum levels. Table Patient parameters before and after S/V Before S/V After S/V P value LVEF (%) 33 [7] 39.5 [15] <0.001 Creatinine (mg/dl) 0.9 [0.4] 0.9 [0.5] 0.15 Creatinine clearance (ml/min) 73 [30] 75 [37] 0.22 Potassium serum levels (mg/dl) 4.5 [0.5] 4.5 [0.6] 0.42 Systolic arterial pressure (mmHg) 116 [23] 112 [27] 0.025 Diastolic arterial pressure (mmHg) 70 [13] 68 [10] 0.498 NT-proBNP (pg/ml) 1831 [3132] 842 [1919] 0.007 NYHA 2.2±0.6 1.6±0.62 <0.001 Values are median [interquartile range] or mean ± standard derivation; S/V: sacubitril-valsartan; LVEF: left ventricle ejection fraction. Conclusions Our experience suggests that S/V is well tolerated and improves functional class and left ventricular function parameters in patients with CTRCD.

scholarly journals Cancer Therapy–Related Cardiac Dysfunction and Heart Failure

2016 ◽  
Vol 9 (2) ◽  
Author(s):  
Carine E. Hamo ◽  
Michelle W. Bloom ◽  
Daniela Cardinale ◽  
Bonnie Ky ◽  
Anju Nohria ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Cardiac Dysfunction

scholarly journals Cancer Therapy–Related Cardiac Dysfunction and Heart Failure

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Michelle W. Bloom ◽  
Carine E. Hamo ◽  
Daniela Cardinale ◽  
Bonnie Ky ◽  
Anju Nohria ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Cardiac Dysfunction

Heart Failure Following Blood Cancer Therapy in Paediatric and Adult Populations

2017 ◽  
Vol 26 ◽  
pp. S135-S136
Author(s):  
J. Franzon ◽  
N. Berry ◽  
S. Ullah ◽  
V. Versace ◽  
A. McCarthy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Blood Cancer

A Review of the Cardiovascular Effects of Oncology Agents

2008 ◽  
Vol 21 (2) ◽  
pp. 146-158 ◽  
Author(s):  
Bradi L. Frei ◽  
Scott A. Soefje
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Adverse Effect ◽  
Cancer Therapy ◽  
Cardiovascular Effects ◽  
Cancer Therapies ◽  
Cardiovascular Toxicity ◽  
Action Monitoring ◽  
Increased Risk ◽  
Chemotherapy Agents

Cardiovascular toxicity is an important adverse effect of several classes of oncology drugs. Because cancer survivors are living longer, the late effects of cancer therapy must be addressed. Many patients diagnosed with cancer are already at an increased risk for cardiovascular disease before drug treatment. Select chemotherapy agents further complicate the issue because of their own ability to induce cardiovascular toxicities or exacerbate preexisting conditions. Hypertension, dyslipidemia, heart failure, and arrhythmia are known consequences of some cancer therapies. This review provides an overview of the epidemiology, mechanism of action, monitoring, and management of these cardiovascular effects.

An emerging epidemic: cancer and heart failure

2016 ◽  
Vol 131 (2) ◽  
pp. 113-121 ◽  
Author(s):  
Paaladinesh Thavendiranathan ◽  
Mark T. Nolan
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Clinical Decision Making ◽  
Prediction Models ◽  
Clinical Decision ◽  
Prevention Strategies ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Adult Cancer Survivors ◽  
Shared Risk

Heart disease and cancer are the two leading causes of mortality globally. Cardiovascular complications of cancer therapy significantly contribute to the global burden of cardiovascular disease. Heart failure (HF) in particular is a relatively common and life-threatening complication. The increased risk is driven by the shared risk factors for cancer and HF, the direct impact of cancer therapy on the heart, an existing care gap in the cardiac care of patients with cancer and the increasing population of adult cancer survivors. The clear relationship between cancer treatment initiation and the potential for myocardial injury makes this population attractive for prevention strategies, targeted cardiovascular monitoring and treatment. However, there is currently no consensus on the optimal strategy for managing this at-risk population. Uniform treatment using cardioprotective medications may reduce the incidence of HF, but would impose frequently unnecessary and burdensome side effects. Ideally we could use validated risk-prediction models to target HF-preventive strategies, but currently no such models exist. In the present review, we focus on evidence and rationales for contemporary clinical decision-making in this novel field and discuss issues, including the burden of HF in patients with cancer, the reasons for the elevated risk and potential prevention strategies.

Prevention of cancer-therapy-related heart failure

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alessandra Cuomo ◽  
Flora Pirozzi ◽  
Pasquale Abete ◽  
Carlo Gabriele Tocchetti ◽  
Valentina Mercurio
Keyword(s):  
Heart Failure ◽  
Cancer Therapy ◽  
Prevention Of Cancer
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