Cardiac dysfunction in solid tumours: scoping review.

Area of Science:

• Cardio-oncology
• Cardiovascular Medicine
• Oncology

Background:

• Cancer can independently damage the heart, separate from cancer treatment-related cardiac dysfunction (CTRCD).
• Understanding these intrinsic cardiac risks is crucial for comprehensive patient care.

Purpose of the Study:

• To identify and characterize cardiovascular abnormalities in adult patients with solid tumors, excluding CTRCD.
• To synthesize existing evidence on the nature and impact of cancer-associated cardiac issues.

Main Methods:

• A comprehensive scoping review was conducted across CINAHL, Embase, and Medline databases, supplemented by handsearching.
• Forty-four studies were included after rigorous screening and data extraction by two researchers.
• Narrative synthesis was employed due to the heterogeneity of the identified studies.

Main Results:

• Cardiovascular abnormalities identified include cardiomyopathy (16 studies), autonomic nervous system dysfunction (10 studies), and biomarker disturbances (9 studies).
• These abnormalities were linked to significant morbidity (e.g., chest pain, dyspnea, fatigue) and a poorer prognosis.
• Prevalence could not be determined due to variable study designs.

Conclusions:

• Cardiovascular dysfunction occurs in solid tumor malignancies independently of CTRCD, even in treatment-naïve patients.
• Manifestations include cardiomyopathies, autonomic dysfunction, and elevated biomarkers, leading to symptoms and reduced survival.
• Clinical practice should integrate these findings, expanding screening criteria to address intrinsic cardiac risks.