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Practice Guideline

. 2021 Aug;37(8):1260-1262.

doi: 10.1016/j.cjca.2021.05.011. Epub 2021 Jun 6.

Long COVID-19: A Primer for Cardiovascular Health Professionals, on Behalf of the CCS Rapid Response Team

Ian Paterson¹, Krishnan Ramanathan², Rakesh Aurora³, David Bewick⁴, Chi-Ming Chow⁵, Brian Clarke⁶, Simone Cowan², Anique Ducharme⁷, Kenneth Gin², Michelle Graham⁸, Anil Gupta⁹, Davinder S Jassal¹⁰, Mustapha Kazmi⁶, Andrew Krahn², Yoan Lamarche¹¹, Ariane Marelli¹², Idan Roifman¹³, Marc Ruel¹⁴, Gurmeet Singh⁸, Larry Sterns¹⁵, Ricky Turgeon¹⁶, Sean Virani², Kenny K Wong¹⁷, Shelley Zieroth¹⁸

Affiliations

¹ Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
² Center for Cardiovascular Innovation, Division of Cardiology, University of British Colombia, Vancouver, British Columbia, Canada.
³ Section of Cardiac Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
⁴ Saint John Regional Hospital, Saint John, New Brunswick, Canada.
⁵ Department of Medicine, University of Toronto, Division of Cardiology, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
⁶ Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
⁷ Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada.
⁸ Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
⁹ Trillium Health Partners, Mississauga, Ontario, Canada.
¹⁰ St Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
¹¹ Department of Surgery, Institut de cardiologie de Montréal, Université de Montréal, Montreal, Quebec, Canada.
¹² McGill University Health Centre, Montreal, Quebec, Canada.
¹³ Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁴ University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
¹⁵ Royal Jubilee Hospital, Victoria, British Columbia, Canada.
¹⁶ Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁷ IWK Health, Dalhousie University, Halifax, Nova Scotia, Canada.
¹⁸ Cardiac Sciences Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: szieroth@sbgh.mb.ca.

PMID: 34090980
PMCID: PMC8180343
DOI: 10.1016/j.cjca.2021.05.011

Practice Guideline

Long COVID-19: A Primer for Cardiovascular Health Professionals, on Behalf of the CCS Rapid Response Team

Ian Paterson et al. Can J Cardiol. 2021 Aug.

. 2021 Aug;37(8):1260-1262.

doi: 10.1016/j.cjca.2021.05.011. Epub 2021 Jun 6.

Authors

Affiliations

¹ Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
² Center for Cardiovascular Innovation, Division of Cardiology, University of British Colombia, Vancouver, British Columbia, Canada.
³ Section of Cardiac Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
⁴ Saint John Regional Hospital, Saint John, New Brunswick, Canada.
⁵ Department of Medicine, University of Toronto, Division of Cardiology, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
⁶ Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
⁷ Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada.
⁸ Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
⁹ Trillium Health Partners, Mississauga, Ontario, Canada.
¹⁰ St Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
¹¹ Department of Surgery, Institut de cardiologie de Montréal, Université de Montréal, Montreal, Quebec, Canada.
¹² McGill University Health Centre, Montreal, Quebec, Canada.
¹³ Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁴ University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
¹⁵ Royal Jubilee Hospital, Victoria, British Columbia, Canada.
¹⁶ Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁷ IWK Health, Dalhousie University, Halifax, Nova Scotia, Canada.
¹⁸ Cardiac Sciences Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: szieroth@sbgh.mb.ca.

PMID: 34090980
PMCID: PMC8180343
DOI: 10.1016/j.cjca.2021.05.011

Abstract
in English, French

It is now widely recognized that COVID-19 illness can be associated with significant intermediate and potentially longer-term physical limitations. The term, "long COVID-19" is used to define any patient with persistent symptoms after acute COVID-19 infection (ie, after 4 weeks). It is postulated that cardiac injury might be linked to symptoms that persist after resolution of acute infection, as part of this syndrome. The Canadian Cardiovascular Society Rapid Response Team has generated this document to provide guidance to health care providers on the optimal management of patients with suspected cardiac complications of long COVID-19.

Il est désormais largement reconnu que la COVID-19 peut être associée à d'importantes limitations physiques à moyen terme et, potentiellement, à plus long terme. Le terme « COVID-19 longue » est utilisé pour décrire tout patient présentant des symptômes persistants après une infection aiguë par le virus de la COVID-19 (soit au-delà de quatre semaines). On suppose qu'une atteinte cardiaque pourrait être liée aux symptômes qui persistent après la disparition de l'infection aiguë, dans le cadre de ce syndrome. Le Groupe de travail sur la réaction rapide à la COVID-19 de la Société canadienne de cardiologie a produit le présent document afin de fournir des conseils aux professionnels de la santé sur la prise en charge optimale des patients chez qui l'on soupçonne des complications cardiaques causées par la COVID-19 longue.

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Review

. 2021 Aug;476(8):3099-3109.

doi: 10.1007/s11010-021-04152-y. Epub 2021 Apr 9.

Mechanisms of anthracycline-mediated cardiotoxicity and preventative strategies in women with breast cancer

Sonu S Varghese¹, Cameron R Eekhoudt¹, Davinder S Jassal^{2

3

4}

Affiliations

¹ Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
² Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. djassal@sbgh.mb.ca.
³ Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. djassal@sbgh.mb.ca.
⁴ Department of Radiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. djassal@sbgh.mb.ca.

PMID: 33835331
DOI: 10.1007/s11010-021-04152-y

Review

Mechanisms of anthracycline-mediated cardiotoxicity and preventative strategies in women with breast cancer

Sonu S Varghese et al. Mol Cell Biochem. 2021 Aug.

. 2021 Aug;476(8):3099-3109.

doi: 10.1007/s11010-021-04152-y. Epub 2021 Apr 9.

Authors

Sonu S Varghese¹, Cameron R Eekhoudt¹, Davinder S Jassal^{2

3

4}

Affiliations

¹ Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
² Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. djassal@sbgh.mb.ca.
³ Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. djassal@sbgh.mb.ca.
⁴ Department of Radiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. djassal@sbgh.mb.ca.

PMID: 33835331
DOI: 10.1007/s11010-021-04152-y

Abstract

While anthracyclines (ACs) are a class of chemotherapeutic agents that have improved the prognosis of many women with breast cancer, it is one of the most cardiotoxic agents used to treat cancer. Despite their reported dose-dependent cardiotoxicity, AC-based chemotherapy has become the mainstay of breast cancer therapy due to its efficacy. Elucidating the mechanisms of anthracycline-mediated cardiotoxicity and associated therapeutic interventions continue to be the main focus in the field of cardio-oncology. Herein, we summarized the current literature surrounding the mechanisms of anthracycline-induced cardiotoxicity, including the role of topoisomerase II inhibition, generation of reactive oxygen species, and elevations in free radicals. Furthermore, this review highlights the molecular mechanisms of potential cardioprotective interventions in this setting. The benefits of pharmaceuticals, including dexrazoxane, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, statins, and antioxidants in this setting, are reviewed. Finally, the mechanisms of emerging preventative interventions within this patient population including nutraceuticals and aerobic exercise are explored.

Keywords: Anthracycline; Breast cancer; Cardioprotection; Cardiotoxicity.

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Long COVID-19: A Primer for Cardiovascular Health Professionals, on Behalf of the CCS Rapid Response Team

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Long COVID-19: A Primer for Cardiovascular Health Professionals, on Behalf of the CCS Rapid Response Team

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Mechanisms of anthracycline-mediated cardiotoxicity and preventative strategies in women with breast cancer

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Mechanisms of anthracycline-mediated cardiotoxicity and preventative strategies in women with breast cancer

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