Cardio-Oncology Rehabilitation to Manage Cardiovascular Outcomes in Cancer Patients and Survivors: A Scientific Statement From the American Heart Association

Cardiovascular disease is a competing cause of death in patients with cancer with early-stage disease. This elevated cardiovascular disease risk is thought to derive from both the direct effects of cancer therapies and the accumulation of risk factors such as hypertension, weight gain, cigarette smo...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2019-05, Vol.139 (21), p.e997-e1012
Main Authors: Gilchrist, Susan C, Barac, Ana, Ades, Philip A, Alfano, Catherine M, Franklin, Barry A, Jones, Lee W, La Gerche, Andre, Ligibel, Jennifer A, Lopez, Gabriel, Madan, Kushal, Oeffinger, Kevin C, Salamone, Jeannine, Scott, Jessica M, Squires, Ray W, Thomas, Randal J, Treat-Jacobson, Diane J, Wright, Janet S
Format: Article
Language:English
Subjects:
American Heart Association
Cancer Survivors
Cardiac Rehabilitation - standards
Cardiology - standards
Cardiotoxicity
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - mortality
Cardiovascular Diseases - physiopathology
Cardiovascular Diseases - therapy
Consensus
Female
Humans
Male
Medical Oncology - standards
Neoplasms - diagnosis
Neoplasms - mortality
Neoplasms - physiopathology
Neoplasms - therapy
Risk Factors
Treatment Outcome
United States
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Summary:Cardiovascular disease is a competing cause of death in patients with cancer with early-stage disease. This elevated cardiovascular disease risk is thought to derive from both the direct effects of cancer therapies and the accumulation of risk factors such as hypertension, weight gain, cigarette smoking, and loss of cardiorespiratory fitness. Effective and viable strategies are needed to mitigate cardiovascular disease risk in this population; a multimodal model such as cardiac rehabilitation may be a potential solution. This statement from the American Heart Association provides an overview of the existing knowledge and rationale for the use of cardiac rehabilitation to provide structured exercise and ancillary services to cancer patients and survivors. This document introduces the concept of cardio-oncology rehabilitation, which includes identification of patients with cancer at high risk for cardiac dysfunction and a description of the cardiac rehabilitation infrastructure needed to address the unique exposures and complications related to cancer care. In this statement, we also discuss the need for future research to fully implement a multimodal model of cardiac rehabilitation for patients with cancer and to determine whether reimbursement of these services is clinically warranted.
ISSN:0009-7322
1524-4539
DOI:10.1161/CIR.0000000000000679