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Review
. Oct-Dec 2019;15(4):258-266.
doi: 10.14797/mdcj-15-4-258.

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

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Free PMC article
Review

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Ali Agha et al. Methodist Debakey Cardiovasc J. .
Free PMC article

Abstract

Innovations and discoveries in cancer therapeutics have improved survival rates in patients with various types of malignancies. At the same time, physicians are identifying an increased number of patients with treatment-related cardiotoxicity. It is imperative that physicians recognize early treatment-related adverse effects to determine the safest therapeutic options for patients with cancer. This manuscript evaluates the role of cardiovascular imaging and biomarkers in identifying cardiotoxicity trigged by various chemotherapeutic agents and summarizes expert consensus statements regarding cardiotoxicity monitoring.

Keywords: CMR; anthracyclines; biomarkers; cardiac magnetic resonance; cardiotoxicity; echocardiogram; immune checkpoint inhibitors.

Conflict of interest statement

Conflict of Interest Disclosure: All authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Figures

Figure 1.
Figure 1.
Proposed timing of cardiotoxicity monitoring with transthoracic echocardiogram for anthracyclines and anti-HER2 therapies in patients with breast cancer without heart failure symptoms. TTE: transthoracic echocardiogram
Figure 2.
Figure 2.
An example of subclinical cardiotoxicity related to anthracycline detected by global longitudinal strain before a decrease in left ventricular ejection fraction (LVEF).
Figure 3.
Figure 3.
Illustrative case of a 37-year-old woman with lymphoma undergoing chemotherapy. She had a decrease in left ventricular (LV) systolic function by echocardiogram (echo) biplane LV ejection fraction (LVEF) quantification, which was verified by cardiac magnetic resonance imaging, and LVEF > 50%. Treatment with anthracycline was resumed without any consequences in LV systolic function. CMR: cardiac magnetic resonance; EDV: end diastolic volume; ESV: end systolic volume

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