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Managing Cancer Patients and Survivors With Advanced Heart Failure

  • Heart Failure (W Tang, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

The number of cancer patients grows globally. An important subset may develop heart failure.

Recent findings

A paucity of data exists regarding outcomes and response to traditional intervention in cancer patients who develop heart failure. Advanced HF treatments in this population require special considerations. Since cancer treatment schedules are anticipated, emphasis should be placed on preventive interventions. Once left ventricular dysfunction ensues, early recognition and prompt treatment of heart failure may improve prognosis. Small studies have shown that guideline-directed medical therapies, cardiac resynchronization therapy, and implantable cardiac defibrillators are equally beneficial in cancer patients yet underutilized as a result of late recognition of heart failure and/or misconception of oncologic prognosis. Additionally, in carefully selected cancer survivors, clinical outcome after implantation of a left ventricular assist device and heart transplantation are comparable with other causes of heart failure.

Summary

Cancer survivors with acceptable prognosis should be evaluated for HF therapies in a timely manner. There remains an urgent need for larger-scale longitudinal studies to determine the best treatment strategies for heart failure in this population.

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Abbreviations

ACE-inhibitor:

Angiotensin converter enzyme-inhibitor

ARNI:

Angiotensin receptor blocker neprilysin inhibitor

CCMP:

Chemotherapy induced cardiomyopathy

CRT:

Cardiac resynchronization therapy

HF:

Heart failure

HFrEF:

Heart failure with reduced ejection fraction

ICD:

Implantable cardiac defibrillator

INTERMACS:

Interagency Registry for Mechanically Assisted Circulatory Support

LV:

Left ventricle

LVAD:

Left ventricular assist device

MCS:

Mechanical circulatory support

NICMP:

Non-ischemic cardiomyopathy

NT-proBNP:

Amino-terminal pro B-type natriuretic peptide

OHT:

Orthotopic heart transplant

RV:

Right ventricle

UNOS:

United Network for Organ Sharing

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Author information

Authors and Affiliations

  1. Department of Cardiology, Ziekenhuis Oost Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium

    Petra Nijst M.D, PhD

  2. Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium

    Petra Nijst M.D, PhD

  3. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA

    W. H. Wilson Tang M.D

  4. Center for Microbiome and Human Health, Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    W. H. Wilson Tang M.D

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Correspondence to Petra Nijst M.D, PhD.

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Conflict of Interest

Petra Nijst and W. H. Wilson Tang declare that they have no conflict of interest. W. H. Wilson Tang is a Section Editor for the journal and was not involved in the review of this manuscript.

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This article is part of the Topical Collection on Heart Failure

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Nijst, P., Tang, W.H.W. Managing Cancer Patients and Survivors With Advanced Heart Failure. Curr Treat Options Cardio Med 23, 73 (2021). https://doi.org/10.1007/s11936-021-00953-y

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