Author + information
- Received November 28, 2017
- Revision received June 6, 2018
- Accepted June 18, 2018
- Published online August 6, 2018.
- Juan Carlos Plana, MDa,∗ (, )
- Paaladinesh Thavendiranathan, MD, SMb,
- Chiara Bucciarelli-Ducci, MD, PhDc and
- Patrizio Lancellotti, MD, PhDd
- aTexas Heart Institute at Baylor St. Luke’s Medical Center, Houston, Texas
- bTed Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
- cBristol Heart Institute, National Institute of Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, United Kingdom
- dDepartments of Cardiology and Cardiovascular Surgery, Heart Valve Clinic, University of Liège Hospital, Grappe Interdisciplinaire de Génoprotéomique Appliquée Cardiovascular Sciences, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium, and Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
- ↵∗Address for correspondence:
Dr. Juan Carlos Plana, Texas Heart Institute at Baylor St. Luke’s Medical Center, 6620 Main Street, Suite 11A.14, BCM 620, Houston, Texas 77030.
Cancer therapy can be associated with both cardiac and vascular toxicity. Advanced multi-modality imaging can be used to stratify patient risk, identify cardiovascular injury during and after therapy, and forecast recovery. Echocardiography continues to be the mainstay in the evaluation of cardiac toxicity. Particularly, echocardiography-based strain imaging is useful for risk stratification of patients at baseline, and detection of subclinical left ventricle (LV) dysfunction during therapy. Cardiac magnetic resonance (CMR) serves a complementary role in the patient with poor echocardiographic or equilibrium radionuclide angiographic image quality or in situations where a more accurate and precise LV ejection fraction measurement is needed to inform decisions regarding discontinuation of chemotherapy. New CMR techniques like T1 and T2 mapping and positron emission tomography (PET) imaging will help us better understand the structural, pathological, and metabolic myocardial changes associated with ventricular dysfunction or release of serum biomarkers. CMR may also be helpful in the evaluation of vascular complications of cancer therapy. Stress echocardiography, stress CMR, computed tomography, and PET are excellent imaging options in the evaluation of ischemia in patients receiving therapies that could potentially cause vasospasm or accelerated atherosclerosis.
This study was supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. Dr. Thavendiranathan is supported by Canadian Institutes of Health Research New Investigator Award FRN 147814. Dr Bucciarelli-Ducci is supported by Bristol National Institute of Health Research Biomedical Research Centre. Dr. Bucciarelli-Ducci is a consultant for Circle Cardiovascular Imaging. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 28, 2017.
- Revision received June 6, 2018.
- Accepted June 18, 2018.
- 2018 American College of Cardiology Foundation
- Central Illustration
- Clinical Case
- Assessment of Baseline Risk of Cardiovascular Complications in Patients Receiving Cancer Therapy
- Prediction of Recovery of Cardiovascular Toxicity
- Detection of Cardiovascular Disease in Long-term Cancer Survivors
- Discussion of the Patient’s Case
- Outcomes in Cardio-oncology and Future Directions