title: Cardiac Complications of Cancer Therapy: Pathophysiology, Identification, Prevention, Treatment, and Future Directions.
abstract: Cardiotoxicity is an important complication of cancer therapy. With a significant improvement in the overall survival and prognosis of patients undergoing cancer therapy, cardiovascular toxicity of cancer therapy has become an important public health issue. Several well-established as well as newer anticancer therapies such as anthracyclines, trastuzumab, and other HER2 receptor blockers, antimetabolites, alkylating agents, tyrosine kinase inhibitors, angiogenesis inhibitors, checkpoint inhibitors, and thoracic irradiation are associated with significant cardiotoxicity.
  
  
  
  Cardiovascular imaging employing radionuclide imaging, echocardiography, and magnetic resonance imaging is helpful in early detection of the cardiotoxicity and prevention of overt heart failure. These techniques also provide important tools for understanding the mechanism of cardiotoxicity of these modalities, which would help develop strategies for the prevention of cardiac morbidity and mortality related to the use of these agents. An understanding of the mechanism of the cardiotoxicity of cancer therapies can help prevent and treat their adverse cardiovascular consequences. Clinical implementation of algorithms based upon cardiac imaging and several non-imaging biomarkers can prevent cardiac morbidity and mortality associated with the use of cardiotoxic cancer therapies.
authors.affiliation: Section of Cardiovascular Medicine, New York Medical College and Westchester Medical Center, 100 Woods Road, Valhalla, NY, USA. dj2700@gmail.com.
authors.forename: Diwakar
authors.initials: D
authors.lastname: Jain
authors.affiliation: Rhode Island Cardiovascular Institute, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA.
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Russell
authors.affiliation: Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.|Nuclear Medicine Division, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Schwartz
authors.affiliation: Heart and Vascular Institute, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
authors.forename: Gurusher S
authors.initials: GS
authors.lastname: Panjrath
authors.affiliation: Section of Cardiovascular Medicine, New York Medical College and Westchester Medical Center, 100 Woods Road, Valhalla, NY, USA.
authors.forename: Wilbert
authors.initials: W
authors.lastname: Aronow
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D057791:Cardiac Imaging Techniques / Q000009:adverse effects* / Q000639:trends; D066126:Cardiotoxicity / Q000517:prevention & control*; D017408:Guidelines as Topic; D006333:Heart Failure / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D011379:Prognosis; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents
keywords: Anthracyclines; Checkpoint inhibitors; Congestive heart failure; Doxorubicin; Radionuclide ventriculography; Trastuzumab