Vol. 36 (2021)
Artículos de revisión

Recommendations for the management of cardiotoxicity related to cancer treatment. Part one

  • Andreina Gómez,
  • Gabriel Parma,
  • Enrique Soto,
  • Rosanna Torighelli,
  • Dahiana Amarillo,
  • Matilde Boada,
  • Liliana Farrero,
  • Claudia Martínez,
  • Federico Pagnussat,
  • Virginia Beneditto,
Andreina Gómez
Coordinadora. Cátedra de Cardiología, Unidad de Cardio-Oncología, Hospital de Clínicas. Montevideo, Uruguay.
Gabriel Parma
Coordinador. Cátedra de Cardiología, Unidad de Cardio-Oncología, Hospital de Clínicas. Montevideo, Uruguay.
Enrique Soto
Servicio de Cardiología, CASMU-IAMPP. Montevideo, Uruguay.
Rosanna Torighelli
Servicio de Cardiología, Instituto Nacional del Cáncer, ASSE. Montevideo, Uruguay.
Dahiana Amarillo
Servicio de Oncología Clínica, Hospital de Clínicas. Montevideo, Uruguay.
Matilde Boada
Cátedra de Hematología, Unidad de Cardio-Oncología, Hospital de Clínicas. Montevideo, Uruguay.
Liliana Farrero
Servicios Oncológicos, Unidad de Cardio-Oncología, Asociación Española. Montevideo, Uruguay.
Claudia Martínez
Servicio de Hematología y Trasplante de progenitores hematopoyéticos, Hospital Maciel, ASSE. Montevideo, Uruguay.
Federico Pagnussat
Servicio de Hematología y Trasplante de progenitores hematopoyéticos, Hospital Maciel, ASSE. Montevideo, Uruguay.
Virginia Beneditto
Centro Cardiológico Americano, Sanatorio Americano, FEPREMI. Montevideo, Uruguay.
DOI: https://doi.org/10.29277/cardio.36.1.7
Published 01-04-2021

Keywords:

Chemotherapy, Cancer, Cardiotoxicity, Cardio-oncology, Ventricular dysfunction, Heart failure, Early detection, Follow-up

Abstract

New oncological therapies have been successful in increasing cancer patient survival, but they have also led to an increase in morbidity and mortality linked to their side effects. During cancer treatment, the development of cardiovascular side effects has a negative impact in prognosis, but also in cancer survivors, in whom cardiovascular diseases and secondary malignancies are the main cause of death.

Cancer related cardiotoxicity is defined as the development of cardiovascular diseases related to cancer treatment. Clinical presentation is broad involving ventricular dysfunction, heart failure, myocardial ischemia, arterial hypertension and arrhythmias among others. This may result from the direct cardiovascular effect of a cancer treatment or accelerated development of cardiovascular diseases.

Frequently, in the literature cardiotoxicity and chemotherapy related ventricular dysfunction are used as synonyms. However, cardiotoxicity includes a broad spectrum of cardiovascular manifestations, thus in this text we refer to chemotherapy related ventricular dysfunction as the presence of left ventricular systolic impairment.

Chemotherapy related ventricular dysfunction and heart failure are two of the most feared complications of cancer treatment due to its impact on cardiovascular and oncological prognosis, affecting treatment options.

Numerous worldwide cardio-onco-hematology societies have emerged to generate clinical practice guidelines and improve the diagnosis and evaluation of cardiovascular cancer treatment side effects.

Cardio-Oncology is a discipline in continuous growth and development. We strongly believe that continuum medical education and a multidisciplinary approach is necessary to provide a quality health care.

This text is the result of a multidisciplinary work involving cardiologists, hematologists and oncologists. It is our goal to provide information to the health care team involved in the assistance of cancer patients. Due to its extension, it will be published in three parts.

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