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Diagnosis of Cardiac Damage: Role of Stress Echo

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Cardiovascular Complications in Cancer Therapy

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

Abstract

Stress echocardiography represents a valuable technique to reveal occult left ventricular dysfunction and coronary artery disease induced by chemo- and radiotherapy treatments. Indeed stress echocardiography can drive rapid cardiac intervention in terms of both chemotherapy dosage reduction and cardio protective strategies. Main indications for stress echocardiography are (i) suspect of coronary artery disease, (ii) evaluation of newly diagnosed LV dysfunction and (iii) assessment of new-onset valvular heart disease. The principal stressors used to reveal chemotherapy-induced cardiac damage are exercise, dobutamine and dipyridamole. Since sensitivity and specificity of different stressors are almost comparable, in cancer patients, the choice of the stressor can be selected according to safety, side effects and efficacy. To detect early signs of left ventricular dysfunction induced by chemotherapy, a complete evaluation of systolic and diastolic function at rest and after stress should be performed. Contractile reserve assessed by either ejection fraction or speckle tracking echocardiography should be determined considering its diagnostic and prognostic power. New technologies applied to stress echocardiography, such as three-dimensional evaluation, would overcome temporal and geometric assumption, but it shows several limitations that reduce its use in clinical practice.

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Author information

Authors and Affiliations

  1. Advanced Biomedical Science, Federico II University Hospital, Naples, Italy

    Ciro Santoro, Roberta Esposito & Maurizio Galderisi

  2. Cardiology Department, Ramon y Cajal University Hospital, Madrid, Spain

    Covadonga Fernández-Golfín & Jose Luis Zamorano Gomez

Authors
  1. Ciro Santoro
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  2. Roberta Esposito
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  3. Covadonga Fernández-Golfín
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  4. Maurizio Galderisi
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  5. Jose Luis Zamorano Gomez
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Corresponding author

Correspondence to Maurizio Galderisi .

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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Santoro, C., Esposito, R., Fernández-Golfín, C., Galderisi, M., Zamorano Gomez, J.L. (2019). Diagnosis of Cardiac Damage: Role of Stress Echo. 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_17

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  • DOI: https://doi.org/10.1007/978-3-319-93402-0_17

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