Left Ventricular Dysfunction in Cancer Treatment: Is it Relevant?

Area of Science:

• Cardiology
• Oncology
• Cardio-oncology

Background:

• Cancer therapies significantly improve survival but introduce cardiotoxicity, including left ventricular (LV) systolic dysfunction.
• While anthracyclines and radiation were known cardiotoxins, modern targeted therapies (HER2 inhibitors, TKIs, etc.) also pose cardiovascular risks.
• The shift towards prolonged targeted cancer therapy necessitates expert cardiovascular risk assessment and management.

Purpose of the Study:

• To review current knowledge on mechanisms, screening, diagnosis, and management of LV dysfunction in cancer patients.
• To apply the ACCF/AHA stages of heart failure (HF) framework for risk stratification and treatment.
• To highlight challenges and opportunities for cardiologist involvement in multidisciplinary cancer care teams.

Main Methods:

• Comprehensive literature review on cancer therapy-related cardiotoxicity.
• Application of the ACCF/AHA stages of heart failure (HF) for risk stratification and management.
• Discussion of clinical practice challenges and collaborative care models.

Main Results:

• Cardiotoxicity is a growing concern with contemporary cancer therapies, affecting LV systolic function.
• A structured approach using HF staging aids in managing cardiotoxicity across the cancer care continuum.
• Multidisciplinary collaboration is crucial for optimizing cardiovascular outcomes in cancer patients.

Conclusions:

• Cardiologists play a vital role in managing LV dysfunction induced by cancer therapies.
• Integrating cardiovascular care within oncology frameworks is essential for improving patient outcomes.
• Proactive management of cardiotoxicity is key for cancer survivors' long-term health.