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Cardiac imaging in cardiotoxicity: a focus on clinical practice

Heart Failure Reviews volume 26, pages 1175–1187 (2021)Cite this article

Abstract

Cancer therapeutics induced cardiotoxicity has emerged as an important factor of long-term adverse cardiovascular outcomes in survivors of various malignant diseases. Early detection of myocardial injury in the setting of cancer treatment is important for the initiation of targeted cardioprotective therapy, in order to prevent irreversible cardiac dysfunction and heart failure, while not withholding a potentially life-saving cancer therapy. Cardiac imaging techniques including echocardiography, cardiac magnetic resonance, and nuclear cardiac imaging are the main tools for the identification of cardiotoxicity. There is also growing evidence for the detection of subclinical cardiac dysfunction in cancer patients by speckle tracking echocardiography. In this review article, we focus on current and emerging data regarding the role of cardiac imaging for the detection of changes in myocardial function related with cancer treatment in clinical practice.

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Abbreviations

LV:

Left ventricular

CMR:

Cardiac magnetic resonance

GLS:

Global longitudinal strain

ECV:

Extracellular volume

LGE:

Late gadolinium enhancement

MUGA:

Multigated radionuclide angiography

SPECT:

Single photon emission tomography

PET:

Positron emission tomography

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MN has received grants by the Deutsche Forschungsgemeinschaft (DFG) through the Sonderforschungsbereich Transregio 19 “Inflammatory Cardiomyopathy” (SFB TR19) (TP B2), and by the University Hospital Giessen and Marburg Foundation Grant “T cell functionality” (UKGM 10/2009). MN has been consultant to the IKDT (Institute for Cardiac Diagnosis and Therapy GmbH, Berlin) 2004–2008, and has received honoraria for presentations and/or participated in advisory boards from Abbot, Abiomed, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Fresenius, Miltenyi Biotech, Novartis, Pfizer, Roche, and Zoll. AGR has received honoraria for presentations from Astra-Zeneca.

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Author notes

  1. George Makavos, Ignatios Ikonomidis, Ioannis Paraskevaidis and Michel Noutsias contributed equally to this work.

Authors and Affiliations

  1. 2nd Department of Cardiology, “Attikon” Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Haidari, 12462, Athens, Greece

    George Makavos, Ignatios Ikonomidis, John Palios, Konstantinos Katogiannis & John Parissis

  2. Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany

    Angelos Rigopoulos & Michel Noutsias

  3. Department of Clinical Therapeutics, “Alexandra” Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece

    Ioannis Paraskevaidis

Authors
  1. George Makavos
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  2. Ignatios Ikonomidis
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  3. John Palios
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  4. Angelos Rigopoulos
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  5. Konstantinos Katogiannis
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  6. John Parissis
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  7. Ioannis Paraskevaidis
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  8. Michel Noutsias
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Correspondence to George Makavos.

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Makavos, G., Ikonomidis, I., Palios, J. et al. Cardiac imaging in cardiotoxicity: a focus on clinical practice. Heart Fail Rev 26, 1175–1187 (2021). https://doi.org/10.1007/s10741-020-09952-w

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  • DOI: https://doi.org/10.1007/s10741-020-09952-w

Keywords

  • Cardiotoxicity
  • Cardiac imaging
  • Three dimensional echocardiography
  • Global longitudinal strain
  • Cardiac magnetic resonance