Echocardiographic Assessment of Cardiotoxic Effects of Cancer Therapy

Patients with cancer can present with difficult management issues, as the medicine can sometimes cause sequelae destructive to healthy tissue. As this population lives longer, cardiotoxic effects are beginning to emerge, but the early recognition of this signal can prove difficult, with too late a r...

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Bibliographic Details
Published in:Current cardiology reports 2016-10, Vol.18 (10), p.99, Article 99
Main Authors: Bottinor, Wendy J., Migliore, Christopher K., Lenneman, Carrie A., Stoddard, Marcus F.
Format: Article
Language:English
Subjects:
Anthracyclines - adverse effects
Antibiotics, Antineoplastic - adverse effects
Cardiology
Cardiotoxicity - diagnostic imaging
Cardiotoxicity - pathology
Echocardiography
Echocardiography (JM Gardin
Heart Ventricles - diagnostic imaging
Heart Ventricles - drug effects
Heart Ventricles - pathology
Humans
Medicine
Medicine & Public Health
Neoplasms - drug therapy
Practice Guidelines as Topic
Risk Assessment
Section Editor
Stroke Volume - drug effects
Topical Collection on Echocardiography
Ventricular Dysfunction, Left - chemically induced
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - pathology
Ventricular Function, Left - drug effects
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Summary:Patients with cancer can present with difficult management issues, as the medicine can sometimes cause sequelae destructive to healthy tissue. As this population lives longer, cardiotoxic effects are beginning to emerge, but the early recognition of this signal can prove difficult, with too late a recognition leading to lifelong cardiac impairment and dysfunction. Cardio-oncology can bridge this difficulty, and echocardiography and its newer imaging abilities are proving efficacious in this population. This article will address common sequelae of cardiotoxic treatment regimens and offer recommendations for echocardiographic surveillance. We recommend echocardiography, preferably three-dimensional and strain imaging, to monitor for cardiotoxic myocardial effects before, during, and after chemotherapy with cardiotoxic drug regimens, particularly anthracycline derivatives. A reduction in left ventricular (LV) global longitudinal strain in all patients, or reduction in LV global circumferential strain or global radial strain in patients at intermediate to high risk for cardiotoxicity, despite normal LV ejection fraction warrants a clinical assessment on the benefits of continuing cardiotoxic chemotherapeutic agents. Lifelong surveillance using echocardiography for cardiotoxicity and radiation-related valvular, pericardial, and coronary artery disease is prudent.
ISSN:1523-3782
1534-3170
DOI:10.1007/s11886-016-0776-z