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Cardiac Complications of Cancer Therapy: Pathophysiology, Identification, Prevention, Treatment, and Future Directions

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Cardiotoxicity is an important complication of cancer therapy. With a significant improvement in the overall survival and prognosis of patients undergoing cancer therapy, cardiovascular toxicity of cancer therapy has become an important public health issue. Several well-established as well as newer anticancer therapies such as anthracyclines, trastuzumab, and other HER2 receptor blockers, antimetabolites, alkylating agents, tyrosine kinase inhibitors, angiogenesis inhibitors, checkpoint inhibitors, and thoracic irradiation are associated with significant cardiotoxicity.

Recent Findings

Cardiovascular imaging employing radionuclide imaging, echocardiography, and magnetic resonance imaging is helpful in early detection of the cardiotoxicity and prevention of overt heart failure. These techniques also provide important tools for understanding the mechanism of cardiotoxicity of these modalities, which would help develop strategies for the prevention of cardiac morbidity and mortality related to the use of these agents.

Summary

An understanding of the mechanism of the cardiotoxicity of cancer therapies can help prevent and treat their adverse cardiovascular consequences. Clinical implementation of algorithms based upon cardiac imaging and several non-imaging biomarkers can prevent cardiac morbidity and mortality associated with the use of cardiotoxic cancer therapies.

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Authors and Affiliations

  1. Section of Cardiovascular Medicine, New York Medical College and Westchester Medical Center, 100 Woods Road, Valhalla, NY, USA

    Diwakar Jain & Wilbert Aronow

  2. Rhode Island Cardiovascular Institute, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA

    Raymond R. Russell

  3. Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA

    Ronald G. Schwartz

  4. Heart and Vascular Institute, George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Gurusher S. Panjrath

  5. Nuclear Medicine Division, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA

    Ronald G. Schwartz

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  1. Diwakar Jain
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Correspondence to Diwakar Jain.

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Conflict of Interest

Diwakar Jain reports grants from Regeneron, Sanofi-Aventis; grants and personal fees from Astellas; and grants from GE.

Raymond R. Russell reports personal fees from Novartis Institutes for Biomedical Research.

Ronald G. Schwartz, Gurusher S. Panjrath, and Wilbert Aronow declare that they have no conflict of interest.

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Jain, D., Russell, R.R., Schwartz, R.G. et al. Cardiac Complications of Cancer Therapy: Pathophysiology, Identification, Prevention, Treatment, and Future Directions. Curr Cardiol Rep 19, 36 (2017). https://doi.org/10.1007/s11886-017-0846-x

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