Narrative Literature Review of Cancer Therapy-related Cardiac Dysfunction

Cancer therapy-related cardiac dysfunction (CTRCD) presents a significant challenge for both oncology and cardiology, necessitating a comprehensive understanding of its pathophysiology, risk factors, diagnostic modalities, and pharmacological interventions. The pathophysiology of CTRCD is multifactorial, and various cancer therapies exert cardiotoxic effects through distinct but overlapping mechanisms, highlighting the need for more personalized preventive and therapeutic interventions. In addition to conventional clinical risk factors, baseline echocardiographic evaluation also plays a critical role in the risk stratification of CTRCD, and numerous studies have demonstrated that baseline left ventricular ejection fraction, global longitudinal strain, and diastolic dysfunction are all predictive of the development of cardiotoxicity. Moreover, continuous surveillance of cardiac function throughout the course of cancer therapy is also paramount. A multimodal diagnostic approach, including cardiac biomarkers, echocardiography, cardiac magnetic resonance imaging, and computed tomography, may facilitate early detection of subclinical myocardial injury and enables timely interventions that may mitigate irreversible cardiac damage. Finally, several pharmacologic strategies have demonstrated promising data in reducing cardiotoxic effects and preserving cardiac function. With these advancements, clinicians can now take a more proactive role in integrating cardio-oncology strategies into treatment protocols, thereby optimizing patient outcomes while minimizing unplanned interruptions in oncologic therapy.