Overview of Oncology: Drug-Induced Cardiac Toxicity DOI Creative Commons
Nilima Rajpal Kundnani,

V Vieira Passini,

Iulia Stefania Carlogea

et al.

Medicina, Journal Year: 2025, Volume and Issue: 61(4), P. 709 - 709

Published: April 12, 2025

Cancer medications can cause cardiac issues, which are difficult to treat in oncologic patients because of the risk complications. In some cases, this may significantly impact their well-being and treatment outcomes. Overall, these complications fall under term “drug induced cardiotoxicity”, mainly due chemotherapy drugs being specifically toxic heart, causing a decrease heart’s capacity pump blood efficiently leading reduction left ventricular ejection fraction (LVEF), subsequently possibly heart failure. Anthracyclines, alkylating agents, targeted therapies for cancer hold potential harmful effects on heart. The incidence heart-related issues varies from patient depends multiple factors, including type medication, dosage, duration treatment, pre-existing conditions. underlying mechanism oncologic-drug-induced cardiovascular is quite complex. One particular group drugs, called anthracyclines, have garnered attention oxidative stress ability direct harm muscle cells. Reactive oxygen species (ROS) by inducing damage programmed cell death Conventional biomarkers alone only indicate degree that has already occurred and, therefore, early detection key. Novel methods like genetic profiling developed detect individuals at risk, prior onset clinical symptoms. Key management strategies—including detection, personalized medicine approaches, use novel biomarkers—play crucial role mitigating cardiotoxicity improving Identification generated alterations association an increased likelihood will allow more approach, aiming decreasing rates events while maintaining high oncological efficacy. Oncology drug-induced managed through combination preventive strategies therapeutic interventions union knowledge.

Language: Английский

Anthracycline Cardiotoxicity in Adult Cancer Patients DOI Creative Commons
Massimiliano Camilli,

Carlo M. Cipolla,

Susan Dent

et al.

JACC CardioOncology, Journal Year: 2024, Volume and Issue: 6(5), P. 655 - 677

Published: Sept. 17, 2024

Language: Английский

Citations

21
Artificial Intelligence–Enhanced Risk Stratification of Cancer Therapeutics–Related Cardiac Dysfunction Using Electrocardiographic Images DOI
Evangelos K. Oikonomou, Veer Sangha, Lovedeep S Dhingra

et al.

Circulation Cardiovascular Quality and Outcomes, Journal Year: 2024, Volume and Issue: 18(1)

Published: Sept. 2, 2024

Risk stratification strategies for cancer therapeutics-related cardiac dysfunction (CTRCD) rely on serial monitoring by specialized imaging, limiting their scalability. We aimed to examine an application of artificial intelligence (AI) ECG images as a surrogate imaging risk biomarkers and its association with early CTRCD. Across US-based health system (2013-2023), we identified 1550 patients (aged, 60 [interquartile range, 51-69] years, 1223 [78.9%] women) without cardiomyopathy who received anthracyclines or trastuzumab breast non-Hodgkin lymphoma had performed ≤12 months before treatment. deployed validated AI model left ventricular systolic baseline defined low-, intermediate-, high-risk groups based AI-ECG probabilities <0.01, 0.01 0.1, ≥0.1 (positive screen), respectively. explored the CTRCD (new cardiomyopathy, heart failure, ejection fraction <50%), <40%, up 12 after In mechanistic analysis, assessed between global longitudinal strain in studies within 15 days each other. Among known (median follow-up, 14.1 13.4-17.1] months), 83 (5.4%), 562 (36.3%), 905 (58.4%) were classified high, intermediate, low risk, respectively, AI-ECG. A versus low-risk screen (≥0.1 <0.01) was associated 3.4-fold 13.5-fold higher incidence (adjusted hazard ratio, 3.35 [95% CI, 2.25-4.99]) <40% 13.52 5.06-36.10]), Post hoc analyses supported increases 6 event. 1428 temporally linked echocardiograms ECGs, worse (global strain, -19% -21% -17%] <0.1, -15% -9%] ≥0.5 [P<0.001]). applied can stratify anthracycline exposure setting therapy.

Language: Английский

Citations

12
Effectiveness of exercise-based interventions in preventing cancer therapy-related cardiac dysfunction in patients with breast cancer: A systematic review and network meta-analysis DOI
Dandan Zhang, Xingyu Xiong,

Hexiao Ding

et al.

International Journal of Nursing Studies, Journal Year: 2025, Volume and Issue: 163, P. 104997 - 104997

Published: Jan. 10, 2025

Language: Английский

Citations

1
Artificial intelligence-enhanced risk stratification of cancer therapeutics-related cardiac dysfunction using electrocardiographic images DOI Creative Commons
Evangelos K. Oikonomou, Veer Sangha, Lovedeep S Dhingra

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: March 15, 2024

ABSTRACT Background Risk stratification strategies for cancer therapeutics-related cardiac dysfunction (CTRCD) rely on serial monitoring by specialized imaging, limiting their scalability. Objectives To examine an artificial intelligence (AI)-enhanced electrocardiographic (AI-ECG) surrogate imaging risk biomarkers, and its association with CTRCD. Methods Across a five-hospital U.S.-based health system (2013-2023), we identified patients breast or non-Hodgkin lymphoma (NHL) who received anthracyclines (AC) and/or trastuzumab (TZM), control cohort receiving immune checkpoint inhibitors (ICI). We deployed validated AI model of left ventricular systolic (LVSD) to ECG images (≥0.1, positive screen) explored i) global longitudinal strain (GLS) measured within 15 days ( n =7,271 pairs); ii) future CTRCD (new cardiomyopathy, heart failure, ejection fraction [LVEF]<50%), LVEF<40%. In the ICI correlated baseline AI-ECG-LVSD predictions downstream myocarditis. Results Higher AI-ECG LVSD were associated worse GLS (−18% [IQR:-20 −17%] predictions<0.1, −12% [IQR:-15 −9%] ≥0.5 p <0.001)). 1,308 AC/TZM (age 59 [IQR:49-67] years, 999 [76.4%] women, 80 [IQR:42-115] follow-up months) screen was ∼2-fold ∼4.8-fold increase in incidence composite endpoint (adj.HR 2.22 [95%CI:1.63-3.02]), LVEF<40% 4.76 [95%CI:2.62-8.66]), respectively. Among 2,056 65 [IQR:57-73] 913 [44.4%] 63 [IQR:28-99] not myocarditis 1.36 [95%CI:0.47-3.93]). Conclusion applied can stratify anthracycline exposure. CONDENSED There is unmet need scalable affordable biomarkers (CTRCD). this hospital system-based, decade-long without cardiomyopathy trastuzumab, algorithm individuals 2-fold 4.8-fold developing any <40%, This supports role interpretation as approach initiating cardiotoxic chemotherapy.

Language: Английский

Citations

8
Diagnosis of cancer therapy-related cardiovascular toxicities: A multimodality integrative approach and future developments DOI
Simon Travers,

Joachim Alexandre,

Lauren A. Baldassarre

et al.

Archives of cardiovascular diseases, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

Citations

0
Cancer and myocardial injury in patients with suspected acute coronary syndrome DOI Creative Commons
Marta Sabaté-Tormos, Alfredo Bardajı́, Óscar M. Peiró

et al.

Cardio-Oncology, Journal Year: 2025, Volume and Issue: 11(1)

Published: Feb. 22, 2025

Cancer and cardiovascular diseases are the leading causes of mortality worldwide, as they share common risk factors exacerbate outcomes when coexist. This study aimed to assess clinical characteristics patients with a history cancer myocardial injury (MI) presenting suspected acute coronary syndrome (ACS) in an emergency setting. retrospective cohort included 3,626 admitted department ACS between 2012 2013. Patients were categorized on basis their presence MI. Clinical variables associations MI all-cause analyzed over four-year follow-up period via univariate multivariate Cox regression models. Of cohort, 10.6% (n = 384) had cancer. Compared other groups, older, more comorbidities, presented higher incidence type 2 infarction (T2MI). At follow-up, was significantly greater among (68.8%) than without (32.4%) noncancer or (42.5% vs. 11.3%, respectively). Multivariate analysis identified patients, particularly those MI, independent predictors mortality. who present departments ACS, cancer, face do. The prevalence T2MI this population underscores need for tailored management strategies.

Language: Английский

Citations

0
Artificial Intelligence to Enhance Precision Medicine in Cardio-Oncology: A Scientific Statement From the American Heart Association DOI
Rohan Khera, Aarti Asnani, Jacob Krive

et al.

Circulation Genomic and Precision Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 24, 2025

Artificial intelligence is poised to transform cardio-oncology by enabling personalized care for patients with cancer, who are at a heightened risk of cardiovascular disease due both the and its treatments. The rising prevalence cancer availability multiple new therapeutic options has resulted in improved survival among expanded scope not only short-term but also long-term risks resulting from However, there considerable heterogeneity risk, driven nature malignancy as well each individual’s unique characteristics. use novel therapies, such targeted therapies immune checkpoint inhibitors, across groups broadened populations which cardiotoxicity become an important consideration therapy. Therefore, ability understand personalize management key target artificial intelligence, can deduce respond complex patterns within data. These advances necessitate overview established biomarkers spanning advanced imaging, diagnostic testing, multi-omics, evidence supporting their use, proven proposed role refining this attain greater precision prediction cardio-oncologic care.

Language: Английский

Citations

0
Cardiovascular Toxicities of Cancer Treatment DOI
Konstantinos C. Siaravas, Christos S. Katsouras, Chrissa Sioka

et al.

Interdisciplinary cancer research, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

Citations

0
When cancer reaches the heart: a case series on rare myocardial and endocardial metastases from squamous cell carcinoma DOI Open Access
Ahmed Basuoni, Ikram Burney, Zamzam Al‐Hashami

et al.

Archive of Clinical Cases, Journal Year: 2025, Volume and Issue: 12(1), P. 44 - 50

Published: March 17, 2025

Cardiac metastases are rare but devastating complications of malignancies. Squamous cell carcinoma (SCC), particularly from non-pulmonary origins, infrequently metastasizes to the heart, making its cardiac involvement an unusual and underreported phenomenon. We present a case series four patients diagnosed with myocardial endocardial SCC at our center over two years. Clinical presentation, imaging modalities, suspected metastatic pathways, management strategies, outcomes were analyzed. Patients (ages 41-74, three males, one female) had primary in vulva, tongue, buccal mucosa, lung. Symptoms varied, including dyspnea, hypotension, chest pain, stroke. All elevated troponin levels. Echocardiography was crucial for initial detection, while PET/CT confirmed metastases, patient undergoing MRI. Hematogenous spread likely pathway most cases. Treatment primarily palliative; only received chemotherapy post-diagnosis. Survival post-cardiac metastasis diagnosis ranged few days six months. Myocardial often indicate advanced disease poor prognosis. Early recognition through multimodal biomarkers such as may facilitate timely palliative interventions. Increased collaboration between oncology cardiology improve supportive care symptom these patients.

Language: Английский

Citations

0
Associations Between Social Determinants of Health, Allostatic Load, and Anthracycline Cardiotoxicity in a Diverse Patient Population DOI Creative Commons
Lili Zhang, Justin Song, Waqas Hanif

et al.

Journal of the American Heart Association, Journal Year: 2025, Volume and Issue: unknown

Published: March 27, 2025

Background Allostatic load (AL) is a measurement of physiological burden chronic stress, operationalized using composite score derived from biomarkers multiple physiologic systems. The relationship between AL and anthracycline cardiotoxicity unclear. Methods Results We included consecutive adult patients who underwent anthracycline‐based chemotherapy 2016 to 2019 for any type cancer. Patients with preexisting heart failure lack measures were excluded the analysis. A was calculated 9 tested before initiating chemotherapy. end point development (defined as clinical or drop in left ventricular ejection fraction≥10% <50%). total 718 analysis (29% Non‐Hispanic White, 31% Black, 40% Hispanic). mean 2.4±1.4 it significantly higher Black Hispanic compared White (2.5±1.3 versus 2.4±1.3 2.1±1.5 P =0.031). In developed cardiotoxicity, than without (2.7±1.4 2.3±1.3, =0.006). independently associated incident after adjusting race ethnicity, age, sex, cardiovascular risk factors, dose, baseline fraction, cancer type, metastasis (hazard ratio 1.20 per 1 increase [95% CI, 1.02–1.43], =0.033). remained additional adjustment social determinants health. Conclusions can be potential important prognostic marker prediction undergoing cardiotoxic treatment independent

Language: Английский

Citations

0