How to utilize current guidelines to manage patients with cancer at high risk for heart failure

Michelle Bloom; Jose A Alvarez-Cardona; Sarju Ganatra; Ana Barac; Iskra Pusic; Daniel Lenihan; Susan Dent

doi:10.1186/s40959-024-00259-5

How to utilize current guidelines to manage patients with cancer at high risk for heart failure

Cardiooncology. 2024 Sep 28;10(1):63. doi: 10.1186/s40959-024-00259-5.

Authors

Michelle Bloom¹, Jose A Alvarez-Cardona¹, Sarju Ganatra², Ana Barac³, Iskra Pusic⁴, Daniel Lenihan⁵, Susan Dent⁶

Affiliations

¹ Leon H. Charney Division of Cardiology, New York University School of Medicine, NYU Langone Health, New York, NY, USA.
² Division of Cardiovascular Medicine, Lahey Hospital and Medical Center, Department of Medicine, Beth Israel Lahey Health, Burlington, MA, USA.
³ Inova Schar Heart and Vascular and Inova Inova Schar Cancer, Falls Church, VA, USA.
⁴ Division of Oncology, Department of Medicine, Washington University, St. Louis, MO, USA.
⁵ International Cardio-Oncology Society, FL and Cape Cardiology Group, Cape Girardeau, Tampa, MO, USA.
⁶ Duke Cancer Institute, Department of Medicine, Duke University, DUMC 3446, Durham, NC, 27710, USA. Susan.dent@duke.edu.

Abstract

Heart failure (HF) in patients with cancer is associated with high morbidity and mortality. The success of cancer therapy has resulted in an exponential rise in the population of cancer survivors, however cardiovascular disease (CVD) is now a major life limiting condition more than 5 years after cancer diagnosis [Sturgeon, Deng, Bluethmann, et al 40(48):3889-3897, 2019]. Prevention and early detection of CVD, including cardiomyopathy (CM) and HF is of paramount importance. The European Society of Cardiology (ESC) published guidelines on Cardio-Oncology (CO) [Lyon, López-Fernández, Couch, et al 43(41):4229-4361, 2022] detailing cardiovascular (CV) risk stratification, prevention, monitoring, diagnosis, and treatment throughout the course and following completion of cancer therapy. Here we utilize a case to summarize aspects of the ESC guideline relevant to HF clinicians, with a focus on risk stratification, early detection, prevention of CM and HF, and the role for guideline directed medical therapy in patients with cancer.

Keywords: Cancer therapy related cardiac dysfunction; Cardio-Oncology; Cardiomyopathy; Guideline directed medical therapy; Heart Failure; Prevention.

Publication types

Review