Protecting the heart in cancer therapy

F1000Res. 2018 Sep 28:7:F1000 Faculty Rev-1566. doi: 10.12688/f1000research.15190.1. eCollection 2018.

Abstract

Recent advances in cancer prevention and management have led to an exponential increase of cancer survivors worldwide. Regrettably, cardiovascular disease has risen in the aftermath as one of the most devastating consequences of cancer therapies. In this work, we define cancer therapeutics-induced cardiotoxicity as the direct or indirect cardiovascular injury or injurious effect caused by cancer therapies. We describe four progressive stages of this condition and four corresponding levels of prevention, each having a specific goal, focus, and means of action. We subsequently unfold this didactic framework, surveying mechanisms of cardiotoxicity, risk factors, cardioprotectants, biomarkers, and diagnostic imaging modalities. Finally, we outline the most current evidence-based recommendations in this area according to multidisciplinary expert consensus guidelines.

Keywords: Cardiovascular disease; biomarkers; cancer; cardioprotection; cardiotoxicity; heart; prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects*
  • Cardiotonic Agents / therapeutic use*
  • Cardiotoxicity / etiology*
  • Cardiotoxins / pharmacology
  • Cardiovascular Diseases / chemically induced
  • Humans
  • Neoplasms / complications*
  • Neoplasms / drug therapy

Substances

  • Antineoplastic Agents
  • Cardiotonic Agents
  • Cardiotoxins