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Current Heart Failure Reports

, Volume 14, Issue 5, pp 398–403 | Cite as

Prevention of Chemotherapy Induced Cardiomyopathy

  • David L. PayneEmail author
  • Anju Nohria
Pathophysiology of Myocardia Failure (I Anand and M Patarroyo-Aponte, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Pathophysiology of Myocardial Failure

Abstract

Purpose of Review

Cardiomyopathy is a significant complication of various cancer treatments and has been best studied in patients receiving anthracyclines and trastuzumab. This paper evaluates strategies to prevent chemotherapy-induced cardiotoxicity.

Recent Findings

Increasing cumulative anthracycline dose, use of ≥2 cardiotoxic therapies, extremes of age, and pre-existing cardiovascular risk factors, or established cardiovascular disease, heighten the risk of developing chemotherapy-induced cardiomyopathy. Continuous rather than bolus anthracycline infusions, liposomal doxorubicin, or concomitant dexrazoxane reduces chemotherapy-induced cardiotoxicity. Treatment with neurohormonal antagonists or statins and exercise training during chemotherapy are promising, but as yet unproven, cardioprotective strategies.

Summary

Identification of high-risk patients and optimization of their underlying cardiovascular risk factors/disease are essential to prevent cardiotoxicity. In patients requiring high-dose anthracyclines, continuous infusions, liposomal doxorubicin, or dexrazoxane should be considered to mitigate cardiotoxicity. Current data do not support the routine use of neurohormonal antagonists or statins as cardioprotective agents in patients treated with cardiotoxic chemotherapies.

Keywords

Cardiotoxicity Chemotherapy-induced cardiomyopathy Anthracyclines Cardio protectant Dexrazoxane Neurohormonal antagonists 

Notes

Compliance with Ethical Standards

Conflict of Interest

David L. Payne, BA and Anju Nohria, MD declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Cardio-Oncology ProgramBrigham and Women’s Hospital/Dana Farber Cancer InstituteBostonUSA

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