[Summary of the ESC position paper on cancer treatment and cardiovascular toxicity].
The numbers of survivors of cancer have increased as a consequence of advances in chemotherapy; however, the side effects of cancer treatment have become increasingly more important. The most frequent side effects include cardiovascular complications, which can lead to acute and delayed morbidity and mortality, often many years later. The discipline of cardio-oncology deals with the prevention, diagnostics and treatment of cardiovascular diseases caused by cancer therapy. The most important cardiovascular side effects of cytostatic therapy are heart failure due to myocardial dysfunction (cardiotoxicity), coronary artery disease, valvular disease and ventricular arrhythmia as a result of QT extension. In addition, arterial hypertension, thromboembolic events, pulmonary hypertension, vasculopathy and pericardial complications can also occur. Fundamentally, a strict limitation of risk factors is necessary to minimize the cardiovascular side effects of potentially cardiotoxic therapeutic procedures. Patients with impaired left ventricular function should be identified by echocardiographic examination prior to cardiotoxic chemotherapy. Treatment with beta blockers and angiotensin-converting enzyme (ACE) inhibitors can also be indicated in asymptomatic patients in order to minimize the effects of chemotherapy on myocardial dysfunction. Prophylactic administration of ACE inhibitors and beta blockers during anthracycline chemotherapy can be considered in patients free of cardiac disease.
Medizinische Klinik 2 - Kardiologie und Angiologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland.
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Medizinische Klinik 2 - Kardiologie und Angiologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland. stephan.achenbach@uk-erlangen.de.
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Achenbach
D006801:Humans; D002309:Cardiology / Q000592:standards; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003935:Diagnostic Techniques, Cardiovascular / Q000592:standards; D004452:Echocardiography / Q000592:standards; D005060:Europe; D019317:Evidence-Based Medicine / Q000592:standards; D019983:Guideline Adherence / Q000592:standards; D008495:Medical Oncology / Q000592:standards; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
Cardiac arrhythmias; Cardio-oncology; Cardiotoxicity; Hypertension; Left ventricular dysfunction