title: Detection and monitoring of cardiotoxicity-what does modern cardiology offer?
abstract: BACKGROUND
  With new anticancer therapies, many patients can have a long life expectancy. Treatment-related comorbidities become an issue for cancer survivors. Cardiac toxicity remains an important side effect of anticancer therapies. Myocardial dysfunction can become apparent early or long after end of therapy and may be irreversible. Detection of cardiac injury is crucial since it may facilitate early therapeutic measures. Traditionally, chemotherapy-induced cardiotoxicity has been detected by measuring changes in left ventricular ejection fraction. This parameter is, however, insensitive to subtle changes in myocardial function as they occur in early cardiotoxicity.
  
  
  CONCLUSIONS
  This review will discuss conventional and modern cardiologic approaches of assessing myocardial function. It will focus on Doppler myocardial imaging, a method which allows to sensitively measure myocardial function parameters like myocardial velocity, deformation (strain), or deformation rate (strain rate) and which has been shown to reliably detect early abnormalities in both regional and global myocardial function in an early stage. Other newer echocardiographic function estimators are based on automated border detection algorithms and ultrasonic integrated backscatter analysis. A further technique to be discussed is dobutamine stress echocardiography. The use of new biomarkers like B-type natriuretic peptide and troponin and less often used imaging techniques like magnetic resonance imaging and computed tomography will also be mentioned.
authors.affiliation: Department of Cardiology, University Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Jurcut
authors.forename: Hans
authors.initials: H
authors.lastname: Wildiers
authors.forename: Javier
authors.initials: J
authors.lastname: Ganame
authors.forename: Jan
authors.initials: J
authors.lastname: D'hooge
authors.forename: Robert
authors.initials: R
authors.lastname: Paridaens
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Voigt
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D015150:Echocardiography, Doppler / Q000379:methods*; D006321:Heart / Q000187:drug effects*; D006331:Heart Diseases / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers