Cardio-oncology: cardiovascular complications of cancer therapy

This paper focuses on three classes of commonly used anticancer drugs, which can cause cardiotoxicity: anthracyclines, monoclonal antibodies exemplified by trastuzumab and tyrosine kinase inhibitors. Anthracyclines can induce cardiomyocyte necrosis and fibrosis. Trastuzumab can cause cardiac stunnin...

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Bibliographic Details
Published in:Future cardiology 2017-07, Vol.13 (4), p.379-396
Main Authors: Henning, Robert J, Harbison, Raymond D
Format: Article
Language:English
Subjects:
Age
angiotensin receptor-blocking agents
angiotensin-converting enzyme inhibitors
Biosynthesis
Breast cancer
cancer chemotherapy
Cancer therapies
Cardiomyocytes
Cardiomyopathy
Cardiovascular disease
Chemotherapy
congestive heart failure
Deoxyribonucleic acid
Diabetes
DNA
Drug dosages
echocardiography
Free radicals
Gender
Heart failure
Hypertension
Kinases
left ventricular dysfunction
Oncology
Patients
radiation therapy
Risk factors
β-adrenergic blocking drugs
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Summary:This paper focuses on three classes of commonly used anticancer drugs, which can cause cardiotoxicity: anthracyclines, monoclonal antibodies exemplified by trastuzumab and tyrosine kinase inhibitors. Anthracyclines can induce cardiomyocyte necrosis and fibrosis. Trastuzumab can cause cardiac stunning. The tyrosine kinase inhibitors can increase systemic arterial pressure and impair myocyte contractility. In addition, radiation therapy to the mediastinum or left chest can exacerbate the cardiotoxicity of these anticancer drugs and can also cause accelerated atherosclerosis, myocardial infarction, heart failure and arrhythmias. Left ventricular ejection fraction measurements are most commonly used to assess cardiac function in patients who receive chemo- or radiation-therapy. However, echocardiographic determinations of global longitudinal strain are more sensitive for detection of early left ventricular systolic dysfunction. Information on patient-risk stratification and monitoring is presented and guidelines for the medical treatment of cardiac dysfunction due to cancer therapies are summarized.
ISSN:1479-6678
1744-8298
DOI:10.2217/fca-2016-0081