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Early Detection of Cardiac Damage

  • Giuseppina Novo
  • Cinzia Nugara
  • Patrizio Lancellotti
Chapter
Part of the Current Clinical Pathology book series (CCPATH)

Abstract

Early detection and quantification of cardiac damage in cancer patients are essential to readily intervene with cardioprotective strategies and avoid the need of the discontinuation of antineoplastic treatment.

Many strategies are available to monitor cardiac function during or after chemotherapy including cardiac imaging (echocardiography, nuclear imaging, cardiac magnetic resonance) and measurement of biomarkers (troponin, natriuretic peptides).

Systematic and repeated monitoring of left ventricle ejection fraction (LVEF) remains the most used technique to diagnose cardiotoxicity in clinical practice. Among the new techniques that evaluate cardiac function, GLS derived by 2D-STE is the best validated technique with a considerable amount of evidences supporting its role in the early detection of cardiotoxicity. Regarding CMR, its low availability and the high cost limit its use to particular subsets of patients.

Measuring biomarkers (troponin and NT-proBNP) also appear to be effective in the prediction of cardiotoxicity; their elevations identify high-risk cohort of cancer patients who may benefit from early cardioprotective medication.

A multimodality approach in selected individuals may provide incremental value in predicting cardiotoxicity and prove to be useful in clinical practice; however further studies are needed for wider validation in the clinical setting.

Keywords

Early detection Cardiotoxicity Echocardiography Biomarkers Multimodality approach Global longitudinal strain 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Giuseppina Novo
    • 1
  • Cinzia Nugara
    • 2
    • 3
  • Patrizio Lancellotti
    • 4
  1. 1.Division of Cardiology, Biomedical Department of Internal Medicine and Specialities (DIBIMIS), University of PalermoPalermoItaly
  2. 2.Biomedical Department of Internal Medicine and Specialities (DIBIMIS), University of PalermoPalermoItaly
  3. 3.IRCCS Bonino PulejoMessinaItaly
  4. 4.University of Liège HospitalLiegeBelgium

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