Abstract
OBJECTIVES: To examine and summarize current international guidelines regarding cardiovascular risk reduction before and during cancer therapy, and to discuss the emerging role of cardio-oncology as a subspecialty in cancer care and the role of cardio-oncology rehabilitation.
DATA SOURCES: Published articles and guidelines.
CONCLUSION: With improvements in cancer detection and the use of novel adjuvant therapies, an increasing number of individuals now survive a cancer diagnosis. However, for some the cost is high - many survivors are now at higher risk of death from cardiovascular disease than from recurrent cancer. Cardiovascular morbidity and mortality are common and associated with common cancer therapies serially administered in adult oncology care.
IMPLICATIONS FOR NURSING PRACTICE: Timely risk-reduction interventions hold promise in reducing cardiovascular morbidity and mortality. Oncology nurses are the key providers to identify baseline risks, perform necessary referrals, provide individualized teaching, and support the patient within the family and community.
PMID: 31983487 [PubMed - as supplied by publisher]
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Modulating the cardiotoxic behaviour of immunoglobulin light chain dimers through point mutations.
//www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--www.tandfonline.com-templates-jsp-_style2-_tandf-images-tandf100x25.gif Related Articles
Modulating the cardiotoxic behaviour of immunoglobulin light chain dimers through point mutations.
Amyloid. 2019;26(sup1):105-106
Authors: Maritan M, Ambrosetti A, Oberti L, Barbiroli A, Diomede L, Romeo M, Lavatelli F, Sormanni P, Palladini G, Bolognesi M, Merlini G, Ricagno S
PMID: 31343361 [PubMed - indexed for MEDLINE]
29 January 2020
12:41
Cardiotoxicity News
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Signaling pathways underlying anthracycline cardiotoxicity.
Signaling pathways underlying anthracycline cardiotoxicity.
Antioxid Redox Signal. 2020 Jan 28;:
Authors: Sala V, Della Sala A, Hirsch E, Ghigo A
Abstract
SIGNIFICANCE: The cardiac side effects of hematological treatments are a major issue of the growing population of cancer survivors, often affecting patient survival even more than the tumor for which the treatment was initially prescribed. Among the most cardiotoxic drugs are anthracyclines, highly potent anti-tumor agents, which still represent a mainstay in the treatment of hematological and solid tumors. Unfortunately, diagnosis, prevention and treatment of cardiotoxicity are still unmet clinical needs which call for a better understanding of the molecular mechanism behind the pathology. Recent Advances: This review article will discuss recent findings on the pathomechanisms underlying the cardiotoxicity of anthracyclines, spanning from DNA and mitochondrial damage to calcium homeostasis, autophagy and apoptosis. Special emphasis will be given to the role of reactive oxygen species and their interplay with major signaling pathways.
CRITICAL ISSUES: Although new promising therapeutic targets and new drugs have started to be identified, their efficacy has been mainly proven in preclinical studies and requires clinical validation.
FUTURE DIRECTIONS: Future studies are awaited to confirm the relevance of recently uncovered targets, as well as identifying new druggable pathways, in more clinically relevant models, including for example human induced pluripotent stem cell-derived cardiomyocytes.
PMID: 31989842 [PubMed - as supplied by publisher]
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Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment? CME.
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Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment? CME.
Methodist Debakey Cardiovasc J. 2019 Oct-Dec;15(4):289-299
Authors: Alvarez-Cardona J, Mitchell J, Lenihan D
Abstract
The acknowledgement of cardiovascular disease as one of the leading causes of mortality and morbidity among cancer survivors is the cornerstone of the growing field of cardio-oncology. Although standardizing treatment for any given disease is often considered ideal, it is important to recognize the value of pursuing a practical and personalized approach when caring for an oncology patient to minimize the risk of treatment-related cardiotoxicity. We hereby discuss a series of cases that illustrate the ways vascular toxicity can manifest in patients with cancer and, when appropriate, provide scientific evidence that supports clinical decision making. We also raise questions about the complex management of these patients while shedding light on future research in this growing field.
PMID: 31988690 [PubMed - in process]
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Electrophysiologic Complications in Cancer Patients.
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Electrophysiologic Complications in Cancer Patients.
Methodist Debakey Cardiovasc J. 2019 Oct-Dec;15(4):282-288
Authors: Lee DH, Chandrashekhar S, Fradley MG
Abstract
In recent years, dramatic advances in both cancer diagnosis and treatment have led to significantly increased survival rates. As such, cardiovascular toxicities due to oncologic treatments are more frequently identified. Although heart failure and cardiomyopathy have historically been the cardiotoxicities most associated with cancer therapeutics, it is now recognized that all components of the cardiovascular system can be affected. In this review, we discuss electrophysiologic complications of cancer treatments, including atrial and ventricular tachyarrhythmias as well as bradyarrhythmias, and recommend a multidisciplinary approach with both cardiologists and oncologists to provide safe and effective care to these patients.
PMID: 31988689 [PubMed - in process]
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Cardiovascular Toxicities of Radiation Therapy.
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Cardiovascular Toxicities of Radiation Therapy.
Methodist Debakey Cardiovasc J. 2019 Oct-Dec;15(4):274-281
Authors: Lewis GD, Farach A
Abstract
As cancer survival outcomes improve, there is a growing focus on survivorship and long-term morbidity after cancer treatment. In particular, there has been concern about the long-term effects of radiotherapy on cardiac function. In this review, we discuss the cardiac effects of radiotherapy in the context of potential confounding factors, examine the potential parameters of interest when studying and modeling cardiac injury, highlight current treatment techniques to minimize radiation to the heart, and consider future areas of improvement and study.
PMID: 31988688 [PubMed - in process]
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Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity.
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Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity.
Methodist Debakey Cardiovasc J. 2019 Oct-Dec;15(4):267-273
Authors: Avila MS, Siqueira SRR, Ferreira SMA, Bocchi EA
Abstract
Recent decades have seen an increase in survival rates for cancer patients, partially explained by earlier diagnoses and new chemotherapeutic agents. However, chemotherapy may be associated with adverse cardiovascular events, including hypertension and pulmonary hypertension, supraventricular and ventricular arrhythmias, cardiomyopathy, and other forms of cardiovascular disease. For patients, the benefits of chemotherapy may be partially obfuscated by deleterious effects on the cardiovascular system, resulting in a significant increase in morbidity and mortality. In this article, we review strategies for prevention and treatment of chemotherapy-related cardiotoxicity.
PMID: 31988687 [PubMed - in process]
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The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics.
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