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Published on: May 16, 2020
[Anthracycline cardiotoxicity]
E Finolezzi1, C Torromeo, B Vincenzi
1Libera Università Campus Biomedico, Via Emilio Longoni 83, 00155 Roma.
Insights
Anthracycline chemotherapy can cause heart damage (cardiotoxicity). Early detection using bidimensional echocardiography is crucial for managing this risk, especially with cumulative doses over 550 mg/m2.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Anthracyclines are vital chemotherapeutic agents.
- Cardiotoxicity is a significant complication of anthracycline therapy.
- Early detection and management are key to improving patient outcomes.
Purpose of the Study:
- To review recent data on anthracycline-induced cardiotoxicity.
- To discuss diagnostic methods for detecting cardiotoxicity.
- To inform specialists and general practitioners on managing this complication.
Main Methods:
- Literature review of MEDLINE and article references.
- Focus on pathogenesis and diagnostic tools for cardiotoxicity.
- Analysis of studies on anthracycline cardiotoxicity.
Main Results:
- Cardiotoxicity presents in acute, chronic, and late patterns.
- Bidimensional echocardiography is a cost-effective, sensitive, and specific diagnostic tool.
- Endomyocardial biopsy and radionuclide angiocardiography are considered gold standards but less practical.
Conclusions:
- Anthracycline cardiotoxicity is a major concern in cancer therapy.
- Cumulative dose >550 mg/m2 is a primary risk factor.
- Bidimensional echocardiography is the preferred method for evaluating anthracycline-related cardiotoxicity.
Purpose:
To provide specialists and general practitioners with a review of the more recent data about anthracycline-induced cardiotoxicity and diagnostic methods utilized to reveal it.
Design:
Reviewers identified studies concerning anthracycline cardiotoxicity, with special emphasis to those dealing with its pathogenesis and tools utilized for diagnosing it, by searching MEDLINE and reviewing references for retrieved articles.
Results:
Three different clinical patterns of cardiotoxicity were described: acute, chronic and late. Highly sensitive tests are necessary for evaluating, during the time, the cardiotoxic effects associated with anthracycline-based therapy and to predict the development of cardiac dysfunction. For this reason, endomyocardic biopsy and radionuclide-based angiocardiography are considered the "gold standard". However, the bidimensional echocardiography is the most commonly performed because of its high specificity and sensitivity combined with low costs.
Conclusions:
The peer review of the most recent scientific literature clearly demonstrate that cardiotoxicity is an important complication of anthracycline-based therapy and that the cumulative dose greater than 550 mg/m2 is the main independent risk factor. For the evaluation of anthracycline-related cardiotoxicity, bidimensional echocardiography remains still the easier and faster method.
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