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Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology
Survival in cancer is continuously improving due to evolving oncological treatment. Therefore, cardiovascular short-term and long-term side effects gain crucial importance for overall outcome. Cardiotoxicity not only presents as heart failure, but also as treatment-resistant hypertension, acute coro...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Vienna
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065248/ https://www.ncbi.nlm.nih.gov/pubmed/35507087 http://dx.doi.org/10.1007/s00508-022-02031-0 |
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author | Bergler-Klein, Jutta Rainer, Peter P. Wallner, Markus Zaruba, Marc-Michael Dörler, Jakob Böhmer, Armin Buchacher, Tamara Frey, Maria Adlbrecht, Christopher Bartsch, Rupert Gyöngyösi, Mariann Fürst, Ursula-Maria |
author_facet | Bergler-Klein, Jutta Rainer, Peter P. Wallner, Markus Zaruba, Marc-Michael Dörler, Jakob Böhmer, Armin Buchacher, Tamara Frey, Maria Adlbrecht, Christopher Bartsch, Rupert Gyöngyösi, Mariann Fürst, Ursula-Maria |
author_sort | Bergler-Klein, Jutta |
collection | PubMed |
description | Survival in cancer is continuously improving due to evolving oncological treatment. Therefore, cardiovascular short-term and long-term side effects gain crucial importance for overall outcome. Cardiotoxicity not only presents as heart failure, but also as treatment-resistant hypertension, acute coronary ischemia with plaque rupture or vasospasm, thromboembolism, arrhythmia, pulmonary hypertension, diastolic dysfunction, acute myocarditis and others. Recent recommendations have proposed baseline cardiac risk assessment and surveillance strategies. Major challenges are the availability of monitoring and imaging resources, including echocardiography with speckle tracking longitudinal strain (GLS), serum biomarkers such as natriuretic peptides (NT-proBNP) and highly sensitive cardiac troponins. This Austrian consensus encompasses cardiotoxicity occurrence in frequent antiproliferative cancer drugs, radiotherapy, immune checkpoint inhibitors and cardiac follow-up considerations in cancer survivors in the context of the Austrian healthcare setting. It is important to optimize cardiovascular risk factors and pre-existing cardiac diseases without delaying oncological treatment. If left ventricular ejection fraction (LVEF) deteriorates during cancer treatment (from >10% to <50%), or myocardial strain decreases (>15% change in GLS), early initiation of cardioprotective therapies (angiotensin-converting enzyme inhibitors, angiotensin or beta receptor blockers) is recommended, and LVEF should be reassessed before discontinuation. Lower LVEF cut-offs were recently shown to be feasible in breast cancer patients to enable optimal anticancer treatment. Interdisciplinary cardio-oncology cooperation is pivotal for optimal management of cancer patients. |
format | Online Article Text |
id | pubmed-9065248 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Vienna |
record_format | MEDLINE/PubMed |
spelling | pubmed-90652482022-05-04 Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology Bergler-Klein, Jutta Rainer, Peter P. Wallner, Markus Zaruba, Marc-Michael Dörler, Jakob Böhmer, Armin Buchacher, Tamara Frey, Maria Adlbrecht, Christopher Bartsch, Rupert Gyöngyösi, Mariann Fürst, Ursula-Maria Wien Klin Wochenschr Position Paper Survival in cancer is continuously improving due to evolving oncological treatment. Therefore, cardiovascular short-term and long-term side effects gain crucial importance for overall outcome. Cardiotoxicity not only presents as heart failure, but also as treatment-resistant hypertension, acute coronary ischemia with plaque rupture or vasospasm, thromboembolism, arrhythmia, pulmonary hypertension, diastolic dysfunction, acute myocarditis and others. Recent recommendations have proposed baseline cardiac risk assessment and surveillance strategies. Major challenges are the availability of monitoring and imaging resources, including echocardiography with speckle tracking longitudinal strain (GLS), serum biomarkers such as natriuretic peptides (NT-proBNP) and highly sensitive cardiac troponins. This Austrian consensus encompasses cardiotoxicity occurrence in frequent antiproliferative cancer drugs, radiotherapy, immune checkpoint inhibitors and cardiac follow-up considerations in cancer survivors in the context of the Austrian healthcare setting. It is important to optimize cardiovascular risk factors and pre-existing cardiac diseases without delaying oncological treatment. If left ventricular ejection fraction (LVEF) deteriorates during cancer treatment (from >10% to <50%), or myocardial strain decreases (>15% change in GLS), early initiation of cardioprotective therapies (angiotensin-converting enzyme inhibitors, angiotensin or beta receptor blockers) is recommended, and LVEF should be reassessed before discontinuation. Lower LVEF cut-offs were recently shown to be feasible in breast cancer patients to enable optimal anticancer treatment. Interdisciplinary cardio-oncology cooperation is pivotal for optimal management of cancer patients. Springer Vienna 2022-05-04 2022 /pmc/articles/PMC9065248/ /pubmed/35507087 http://dx.doi.org/10.1007/s00508-022-02031-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Position Paper Bergler-Klein, Jutta Rainer, Peter P. Wallner, Markus Zaruba, Marc-Michael Dörler, Jakob Böhmer, Armin Buchacher, Tamara Frey, Maria Adlbrecht, Christopher Bartsch, Rupert Gyöngyösi, Mariann Fürst, Ursula-Maria Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology |
title | Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology |
title_full | Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology |
title_fullStr | Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology |
title_full_unstemmed | Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology |
title_short | Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies: Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology |
title_sort | cardio-oncology in austria: cardiotoxicity and surveillance of anti-cancer therapies: position paper of the heart failure working group of the austrian society of cardiology |
topic | Position Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065248/ https://www.ncbi.nlm.nih.gov/pubmed/35507087 http://dx.doi.org/10.1007/s00508-022-02031-0 |
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