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Atrial Fibrillation, Cancer and Echocardiography

Nonvalvular atrial fibrillation (AF) is a relatively frequent arrhythmia in cancer patients; it is possibly due to direct effect of cancer or consequence of cancer therapies. AF creates important problems for both therapeutic management and prognosis in cancer patients. The anticoagulation of cancer...

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Autores principales: Galderisi, Maurizio, Esposito, Roberta, Sorrentino, Regina, Mura, Lucia La, Santoro, Ciro, Tufano, Antonella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293868/
https://www.ncbi.nlm.nih.gov/pubmed/32566464
http://dx.doi.org/10.4103/jcecho.jcecho_8_19
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author Galderisi, Maurizio
Esposito, Roberta
Sorrentino, Regina
Mura, Lucia La
Santoro, Ciro
Tufano, Antonella
author_facet Galderisi, Maurizio
Esposito, Roberta
Sorrentino, Regina
Mura, Lucia La
Santoro, Ciro
Tufano, Antonella
author_sort Galderisi, Maurizio
collection PubMed
description Nonvalvular atrial fibrillation (AF) is a relatively frequent arrhythmia in cancer patients; it is possibly due to direct effect of cancer or consequence of cancer therapies. AF creates important problems for both therapeutic management and prognosis in cancer patients. The anticoagulation of cancer patients presenting AF is a main issue because of the difficult balance between thromboembolic and bleeding risks, both elevated in this clinical setting. A comprehensive echo Doppler examination is mandatory to identify the eventual sources of emboli in left atrial (LA) cavity, mainly the transesophageal echocardiography (TEE), but also to predict the subsequent development of heart failure. This evaluation is particularly important to graduate anticoagulation and to prevent and manage symptoms/signs of heart failure. The performance of a TEE precardioversion is highly encouraged to detect possible thrombi in LA appendage. A careful assessment of LA size (LA volume index) and function (LA emptying fraction and/or LA strain) should always be planned to predict the possible recurrence of AF paroxysmal episodes. This is in fact a key action, not only from the cardiologic point of view but also for the oncologic perspectives in individual situations. Patients with larger left atrium and more impaired LA function should be addressed toward a less aggressive cancer treatment, with drugs which are not associated or are poorly related with the risk of AF development. A correct and comprehensive echocardiographic assessment could even induce the oncologist to change the cancer management balancing the oncologic and the cardiac risk.
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spelling pubmed-72938682020-06-19 Atrial Fibrillation, Cancer and Echocardiography Galderisi, Maurizio Esposito, Roberta Sorrentino, Regina Mura, Lucia La Santoro, Ciro Tufano, Antonella J Cardiovasc Echogr Review Article Nonvalvular atrial fibrillation (AF) is a relatively frequent arrhythmia in cancer patients; it is possibly due to direct effect of cancer or consequence of cancer therapies. AF creates important problems for both therapeutic management and prognosis in cancer patients. The anticoagulation of cancer patients presenting AF is a main issue because of the difficult balance between thromboembolic and bleeding risks, both elevated in this clinical setting. A comprehensive echo Doppler examination is mandatory to identify the eventual sources of emboli in left atrial (LA) cavity, mainly the transesophageal echocardiography (TEE), but also to predict the subsequent development of heart failure. This evaluation is particularly important to graduate anticoagulation and to prevent and manage symptoms/signs of heart failure. The performance of a TEE precardioversion is highly encouraged to detect possible thrombi in LA appendage. A careful assessment of LA size (LA volume index) and function (LA emptying fraction and/or LA strain) should always be planned to predict the possible recurrence of AF paroxysmal episodes. This is in fact a key action, not only from the cardiologic point of view but also for the oncologic perspectives in individual situations. Patients with larger left atrium and more impaired LA function should be addressed toward a less aggressive cancer treatment, with drugs which are not associated or are poorly related with the risk of AF development. A correct and comprehensive echocardiographic assessment could even induce the oncologist to change the cancer management balancing the oncologic and the cardiac risk. Wolters Kluwer - Medknow 2020-04 2020-04-10 /pmc/articles/PMC7293868/ /pubmed/32566464 http://dx.doi.org/10.4103/jcecho.jcecho_8_19 Text en Copyright: © 2020 Journal of Cardiovascular Echography http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Galderisi, Maurizio
Esposito, Roberta
Sorrentino, Regina
Mura, Lucia La
Santoro, Ciro
Tufano, Antonella
Atrial Fibrillation, Cancer and Echocardiography
title Atrial Fibrillation, Cancer and Echocardiography
title_full Atrial Fibrillation, Cancer and Echocardiography
title_fullStr Atrial Fibrillation, Cancer and Echocardiography
title_full_unstemmed Atrial Fibrillation, Cancer and Echocardiography
title_short Atrial Fibrillation, Cancer and Echocardiography
title_sort atrial fibrillation, cancer and echocardiography
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293868/
https://www.ncbi.nlm.nih.gov/pubmed/32566464
http://dx.doi.org/10.4103/jcecho.jcecho_8_19
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