Chemotherapy-induced cardiomyopathy.
Cardiomyopathy is an adverse outcome of antineoplastic drug therapy that has become increasingly relevant in the management of cancer survivors. As the efficacy of anticancer treatments has improved, long-term outcomes are altered by the development of cardiotoxicity, which may be associated with an even worse prognosis than that of the underlying malignancy. From the research into mechanisms, prevention, and treatment, the specialized field of cardio-oncology has evolved, but the recognition and appropriate management of these patients is important for the general internist and general cardiologist as well. Although antineoplastic chemotherapy can cause multiple forms of cardiotoxicity, including arrhythmia, pericardial disease, valvular dysfunction, and myocardial ischemia, in this review we will focus on chemotherapeutic agents associated with cardiomyopathies, from the anthracyclines to newer, the so-called targeted agents such as tyrosine kinase inhibitors. We also review the diagnostic modalities for chemotherapy-induced cardiomyopathy as well as the prevention and treatment strategies which may prolong the lives of those suffering from cancer.
Department of Medicine, Beth Israel Deaconess Medical Center, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA, 02215, USA. angela.y.higgins@gmail.com.
Angela Y
AY
Higgins
Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Thomas D
TD
O'Halloran
Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
James D
JD
Chang
D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000175:diagnosis*; D066126:Cardiotoxicity / Q000517:prevention & control*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy
D018943:Anthracyclines; D000970:Antineoplastic Agents; D015415:Biomarkers
Cancer; Cardio-oncology; Cardiomyopathy; Chemotherapy; Heart failure