Cancer Therapy-Related Cardiac Dysfunction and Heart Failure: Part 2: Prevention, Treatment, Guidelines, and Future Directions

Circ Heart Fail. 2016 Feb;9(2):e002843. doi: 10.1161/CIRCHEARTFAILURE.115.002843.

Abstract

Success with oncologic treatment has allowed cancer patients to experience longer cancer-free survival gains. Unfortunately, this success has been tempered by unintended and often devastating cardiac complications affecting overall patient outcomes. Cardiac toxicity, specifically the association of several cancer therapy agents with the development of left ventricular dysfunction and cardiomyopathy, is an issue of growing concern. Although the pathophysiologic mechanisms behind cardiac toxicity have been characterized, there is currently no evidence-based approach for monitoring and management of these patients. In the first of a 2-part review, we discuss the epidemiologic, pathophysiologic, risk factors, and imaging aspects of cancer therapy-related cardiac dysfunction and heart failure. In this second part, we discuss the prevention and treatment aspects in these patients and conclude with highlighting the evidence gaps and future directions for research in this area.

Keywords: cardiomyopathies; cardiotoxicity; heart; heart failure; trastuzumab.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Algorithms
  • Animals
  • Antineoplastic Agents / adverse effects*
  • Cardiomyopathies / chemically induced
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / prevention & control*
  • Cardiomyopathies / therapy*
  • Critical Pathways
  • Heart Failure / chemically induced
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology
  • Heart Failure / prevention & control*
  • Heart Failure / therapy*
  • Humans
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Risk Factors
  • Treatment Outcome
  • Ventricular Dysfunction, Left / chemically induced
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / prevention & control*
  • Ventricular Dysfunction, Left / therapy*
  • Ventricular Function, Left / drug effects

Substances

  • Antineoplastic Agents