scholarly journals Cardio-Oncology: The Role of Echocardiography in Cancer Patients

2021 ◽  
Author(s):  
Theodoros Ntoskas
Keyword(s):  
Cancer Therapy ◽  
Cancer Patients ◽  
Cardiac Imaging ◽  
Early Recognition ◽  
Cardiac Injury ◽  
Three Dimensional ◽  
Cardiovascular Complications ◽  
Cardiac Events ◽  
Ongoing Research ◽  
Wide Availability

Cardio-oncology is a rapidly emerging medical field that focusses on the improvement of the quality of life of cancer patients by preventing and treating the adverse cardiovascular complications of cancer therapy. Early recognition of cancer therapy-related cardiac dysfunction (CTRCD) provides an opportunity to mitigate cardiac injury and risk of developing late cardiac events. Cardiac imaging, and in particular, transthoracic echocardiography, plays an essential role in the baseline assessment, the detection and the surveillance of CRTCD in patients during and after the cancer therapy. Although the frequency of screening for the cardiotoxicity in patients undergoing active treatments and cancer survivors remains a topic of debate and ongoing research, echocardiography continues to be the leader for continuous monitoring by imaging due to the wide availability, lack of exposure to radiation, ability to recognise the effects on cardiac function and assess haemodynamics and other cardiac structures. The cardiac imaging applied to cardio-oncology includes standard and advanced (speckle tracking and three-dimensional (3D)) echocardiography.

scholarly journals Anti-cancer Therapy Leads to Increased Cardiovascular Susceptibility to COVID-19

2021 ◽  
Vol 8 ◽  
Author(s):  
Caroline Lozahic ◽  
Helen Maddock ◽  
Hardip Sandhu
Keyword(s):  
Cancer Therapy ◽  
Cancer Patients ◽  
Respiratory Disease ◽  
Myocardial Injury ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
World Health ◽  
Cancer Drug ◽  
Health Crisis ◽  
Anti Cancer

Anti-cancer treatment regimens can lead to both acute- and long-term myocardial injury due to off-target effects. Besides, cancer patients and survivors are severely immunocompromised due to the harsh effect of anti-cancer therapy targeting the bone marrow cells. Cancer patients and survivors can therefore be potentially extremely clinically vulnerable and at risk from infectious diseases. The recent global outbreak of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its infection called coronavirus disease 2019 (COVID-19) has rapidly become a worldwide health emergency, and on March 11, 2020, COVID-19 was declared a global pandemic by the World Health Organization (WHO). A high fatality rate has been reported in COVID-19 patients suffering from underlying cardiovascular diseases. This highlights the critical and crucial aspect of monitoring cancer patients and survivors for potential cardiovascular complications during this unprecedented health crisis involving the progressive worldwide spread of COVID-19. COVID-19 is primarily a respiratory disease; however, COVID-19 has shown cardiac injury symptoms similar to the cardiotoxicity associated with anti-cancer therapy, including arrhythmia, myocardial injury and infarction, and heart failure. Due to the significant prevalence of micro- and macro-emboli and damaged vessels, clinicians worldwide have begun to consider whether COVID-19 may in fact be as much a vascular disease as a respiratory disease. However, the underlying mechanisms and pathways facilitating the COVID-19-induced cardiac injury in cancer and non-cancer patients remain unclear. Investigations into whether COVID-19 cardiac injury and anti-cancer drug-induced cardiac injury in cancer patients and survivors might synergistically increase the cardiovascular complications and comorbidity risk through a “two-hit” model are needed. Identification of cardiac injury mechanisms and pathways associated with COVID-19 development overlapping with anti-cancer therapy could help clinicians to allow a more optimized prognosis and treatment of cancer survivors suffering from COVID-19. The following review will focus on summarizing the harmful cardiovascular risk of COVID-19 in cancer patients and survivors treated with an anti-cancer drug. This review will improve the knowledge of COVID-19 impact in the field of cardio-oncology and potentially improve the outcome of patients.

scholarly journals Improved cardiovascular risk stratification with PET: [18F]meta-fluorobenzylguanidine as a potential cardiac radiotracer

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Austin Meyer ◽  
Scott Snyder
Keyword(s):  
Cardiovascular Disease ◽  
Neuroendocrine Tumors ◽  
Cardiac Imaging ◽  
Imaging Modality ◽  
Cardiac Injury ◽  
The United States ◽  
Direct Access ◽  
Cardiac Events ◽  
One Pot ◽  
Personalized Care

Background and Hypothesis:  Cardiovascular disease is the leading cause of death in the United States each year, exceeding 600,000 deaths and costing over $200B. Sympathetic dysfunction in cardiac tissue has been shown to occur in patients with recent cardiac injury or longstanding disease. The SPECT radiotracer, meta-[123I]iodobenzylguanidine (MIBG), has been used to image neuroendocrine tumors as well as global cardiac sympathetic tone through the human norepinephrine transporter-1. We will determine the utility and improved imaging the PET radiotracer meta-[18F]fluorobenzylguanidine (MFBG) can afford in cardiac care. MFBG has shown several improvements over MIBG in neuroendocrine tumors but has proven difficult to reliably synthesize.  Project Methods:  A novel synthetic pathway of MFBG utilizing copper accelerated Sandmeyer fluorination conditions is being developed to streamline its radiosynthesis from seven manipulations and an unstable precursor to four with more stable intermediates.   We also explored where MFBG may be useful in cardiology by performing a literature review through the PubMed MeSH database published after 2010.  Results:  We have developed a new MFBG precursor in one step from commercially available compounds and a one-pot automated radiosynthesis is currently in development. This improves upon current methods and may provide increased clinical availability of MFBG for future studies.  MIBG has shown prognostic value for the incidence of severe cardiac events but cannot provide any local innervation data. The PET radiotracer, [11C]hydroxyephedrine, can display local denervation within the myocardium. However, its 20.3 minute half-life prevents its widespread use beyond hospitals with direct access to a radiochemistry laboratory. To our knowledge, no cardiac imaging has been investigated using MFBG.  Conclusion and Potential Impact:  We believe MFBG could provide similar improvements to cardiac imaging as in neuroendocrine tumors. With a novel synthetic method being developed, we hope to begin pre-clinical imaging studies and provide future cardiologists with a new prognostic imaging modality which can direct personalized care to patients with cardiovascular disease. 

scholarly journals Management of COVID-19 in cancer patients receiving cardiotoxic anti-cancer therapy. Future recommendations for cardio-oncology

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hasan Kobat ◽  
Islam Elkonaissi ◽  
Mehmet Tevfik Dorak ◽  
Shereen Nabhani-Gebara
Keyword(s):  
Cancer Therapy ◽  
Cancer Patients ◽  
Immune Suppression ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Supportive Treatment ◽  
Cardiac Events ◽  
Increased Risk ◽  
Anti Cancer ◽  
Lung Functions

Cardiotoxicity induced by anti-cancer treatment has become a significant threat as the number of cardiotoxic anti-cancer agents is growing. Cancer patients are at an increased risk of contracting coronavirus disease 2019 (COVID-19) because of immune suppression caused by anti-cancer drugs and/or supportive treatment. Deterioration in lung functions due to COVID-19 is responsible for many cardiac events. The presence of COVID-19 and some of its treatment modalities may increase the chance of cardiotoxicity development in cancer patients receiving potentially cardiotoxic agents. This review provides evidence-based information on the cardiotoxicity risk in cancer patients clinically diagnosed with COVID-19 who are receiving potentially cardiotoxic anti-cancer agents. Proposed strategies relating to the management of this patient cohorts are also discussed.

scholarly journals ONCOR: design of the Dutch cardio-oncology registry

2020 ◽  
Author(s):  
J. A. M. Kamphuis ◽  
M. Linschoten ◽  
M. J. Cramer ◽  
F. Alsemgeest ◽  
D. J. W. van Kessel ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Data Collection ◽  
Care Pathway ◽  
Interdisciplinary Approach ◽  
Cardiovascular Complications ◽  
Outcome Data ◽  
Cardiac Events ◽  
Oncological Treatment ◽  
Oncological Care ◽  
The Impact

Abstract Background The relative new subspecialty ‘cardio-oncology’ was established to meet the growing demand for an interdisciplinary approach to the management of cancer therapy–related cardiovascular adverse events. In recent years, specialised cardio-oncology services have been implemented worldwide, which all strive to improve the cardiovascular health of cancer patients. However, limited data are currently available on the outcomes and experiences of these specialised services, and optimal strategies for cardio-oncological care have not been established. Aim The ONCOR registry has been created for prospective data collection and evaluation of cardio-oncological care in daily practice. Methods Dutch hospitals using a standardised cardio-oncology care pathway are included in this national, multicentre, observational cohort study. All patients visiting these cardio-oncology services are eligible for study inclusion. Data collection at baseline consists of the (planned) cancer treatment and the cardiovascular risk profile, which are used to estimate the cardiotoxic risk. Information regarding invasive and noninvasive tests is collected during the time patients receive cardio-oncological care. Outcome data consist of the incidence of cardiovascular complications and major adverse cardiac events, and the impact of these events on the oncological treatment. Discussion Outcomes of the ONCOR registry may aid in gaining more insight into the incidence of cancer therapy–related cardiovascular complications. The registry facilitates research on mechanisms of cardiovascular complications and on diagnostic, prognostic and therapeutic strategies. In addition, it provides a platform for future (interventional) studies. Centres with cardio-oncology services that are interested in contributing to the ONCOR registry are hereby invited to participate.

scholarly journals Reporting of coronary artery calcification on chest CT studies in breast cancer patients at high risk of cancer therapy related cardiac events

2018 ◽  
Vol 18 ◽  
pp. 12-16 ◽  
Author(s):  
William J. Phillips ◽  
Christopher Johnson ◽  
Angeline Law ◽  
Michele Turek ◽  
Alex R. Small ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Coronary Artery ◽  
High Risk ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Chest Ct ◽  
Breast Cancer Patients ◽  
Cardiac Events ◽  
Risk Of Cancer ◽  
Ct Studies

Three-dimensional speckle-tracking echocardiography – a further step in the non-invasive three-dimensional cardiac imaging

2012 ◽  
Vol 153 (40) ◽  
pp. 1570-1577 ◽  
Author(s):  
Attila Nemes ◽  
Anita Kalapos ◽  
Péter Domsik ◽  
Tamás Forster
Keyword(s):  
Cardiac Imaging ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Myocardial Mechanics ◽  
Non Invasive ◽  
Imaging Methodology ◽  
Invasive Evaluation

Three-dimensional speckle-tracking echocardiography is a new cardiac imaging methodology, which allows three-dimensional non-invasive evaluation of the myocardial mechanics. The aim of this review is to present this new tool emphasizing its diagnostic potentials and demonstrating its limitations, as well. Orv. Hetil., 2012, 153, 1570–1577.

KIDNEY INJURY IN CANCER THERAPY

2018 ◽  
Vol 22 (5) ◽  
pp. 17-24 ◽  
Author(s):  
E. V. Burnasheva ◽  
Y. V. Shatokhin ◽  
I. V. Snezhko ◽  
A. A. Matsuga
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Cytotoxic Effect ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Chemotherapeutic Agents ◽  
Oxygen Intermediates ◽  
Circulating Blood Volume

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular  injury, nephrotoxic drugs including chemotherapeutic agents. Also  bone marrow transplantation complications, infections with immune  suppression (including septicemia), tumor lysis syndrome should be  taken into account. Chemotherapeutic agents are a common cause  of acute kidney injury but can potentially lead to chronic kidney  disease development in cancer patients. This article summarizes risk  factors of acute kidney injury in cancer patients. Risk factors are  divided into two groups. The systemic are decrease of total  circulating blood volume, infiltration of kidney tissue by tumor cells,  dysproteinemia, electrolyte disturbances. The local (renal) risk  factors are microcirculation disturbances, drugs biotransformation  with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its  sensitivity to ischemia. Drug-related risk factors include: drugs  combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular  precipitates. Early diagnosis, timely prevention and treatment of  these complications provide significantly improve nononcologic results of treatment.

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