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Heart Failure and Left Ventricular Dysfunction

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Cardiovascular Complications in Cancer Therapy

Part of the book series: Current Clinical Pathology ((CCPATH))

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Abstract

Heart failure (HF) and left ventricular (LV) dysfunction are the most concerning and serious cardiovascular complications of cancer therapies and cause an increase in morbidity and mortality. Some cancer treatments induce left ventricular dysfunction that appears early after exposure and therefore may adversely affect oncological therapy, while others generate cardiac injuries resulting in clinical problems only years later.

The risk of cardiotoxicity (CTX) is related both to the use of some anticancer agents (anthracyclines, alkylating agents, antimetabolites, antimicrotubule agents, monoclonal antibodies, small molecule tyrosine kinase inhibitors, and proteasome inhibitors) or radiotherapy and to the presence of non-treatment-related conditions such as cardiovascular risk factors, comorbidities, and compromised cardiac function.

The goals of treatment in patients with HF, whatever the cause is, are to improve their clinical status, functional capacity, and quality of life, prevent hospital admission, and reduce mortality. However, the real challenge of cardio-oncology is to avoid that damage occurs at all.

For this reason early diagnosis of myocardial impairment is crucial, and it is advisable that patients treated with antineoplastic drugs undergo cardiological evaluation including electrocardiography (ECG) and measurement of cardiac function with the best available imaging technique (echocardiography, nuclear imaging, cardiac magnetic resonance [CMR]) and biomarkers (troponin, natriuretic peptides) before, during, and after antineoplastic treatment.

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Authors and Affiliations

  1. Division of Cardiology, Biomedical Department of Internal Medicine and Specialities (DIBIMIS), University of Palermo, Palermo, Italy

    Giuseppina Novo

  2. Biomedical Department of Internal Medicine and Specialities (DIBIMIS), Division of Cardiology, University Hospital P. Giaccone, Palermo, Italy

    Cinzia Nugara

  3. IRCCS Bonino Pulejo, Messina, Italy

    Cinzia Nugara

  4. University of Liège Hospital, Liege, Belgium

    Patrizio Lancellotti

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  1. Giuseppina Novo
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  2. Cinzia Nugara
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  3. Patrizio Lancellotti
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Correspondence to Giuseppina Novo .

Editor information

Editors and Affiliations

  1. Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy

    Antonio Russo

  2. University of Palermo, School of Medicine, Palermo, Italy

    Giuseppina Novo

  3. Department of Cardiology, University of Liège, Liege, Belgium

    Patrizio Lancellotti

  4. Temple University College of Science and Technology, Philadelphia, PA, USA

    Antonio Giordano

  5. Cardiology Department, University of Lisbon, Lisbon, Portugal

    Fausto J. Pinto

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Novo, G., Nugara, C., Lancellotti, P. (2019). Heart Failure and Left Ventricular Dysfunction. In: Russo, A., Novo, G., Lancellotti, P., Giordano, A., Pinto, F. (eds) Cardiovascular Complications in Cancer Therapy. Current Clinical Pathology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-93402-0_7

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