Prevention of cancer therapy-related cardiac dysfunction and heart failure in cancer patients and survivors. A Clinical Consensus Statement of the Heart Failure Association, the European Association of Preventive Cardiology of the ESC, and the ESC Council of Cardio-Oncology.

Abstract

Despite advances in cancer treatments with significant improvement in patient outcomes, chemotherapy, targeted molecular therapies and radiotherapy may cause a range of cardiovascular complications, such as cancer therapy-related cardiac dysfunction (CTRCD), which represents a broad spectrum of possible presentation and aetiological link with the broad scope of various cancer therapies, including chemotherapy, targeted agents, immunotherapies, and radiation therapy, aiming at reducing the associated morbidity and mortality. However, practical guidelines on the primary prevention of CTRCD in high-risk patients, a key element in improving prognosis, are lacking in cancer patients and related evidence remains inconclusive. This Clinical Consensus Statement, authored by experts from the Heart Failure Association (HFA) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC), and the ESC Council of Cardio-Oncology, aims to discuss the definition and epidemiology of CTRCD, the implicated factors for risk stratification, and the appropriate early diagnostic pathways, while focusing on lifestyle modifications, and pharmacological interventions to reduce the incidence of CTRCD. In addition, a holistic cardio-oncology management approach is advised for prevention and long-term management.