Simon Wernhart MD, PhD , Caterina Fiorentini MD , Martin Halle MD
{"title":"Exercise Training in Breast Cancer Survivors","authors":"Simon Wernhart MD, PhD , Caterina Fiorentini MD , Martin Halle MD","doi":"10.1016/j.jaccao.2025.05.004","DOIUrl":"10.1016/j.jaccao.2025.05.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 427-429"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony F. Yu MD, MS , Chau T. Dang MD , Chaya S. Moskowitz PhD , Akriti Mishra Meza MS , Patricia DeFusco MD , Eric Oligino MD , Carol L. Chen MD , Rachel Sanford MD , Pamela Drullinsky MD , Jacqueline Bromberg MD, PhD , Serena Wong MD , Shanu Modi MD , Justine Jorgensen BS , Kevin C. Oeffinger MD , Richard M. Steingart MD , Jennifer E. Liu MD
{"title":"Cardiac Safety of Reduced Cardiotoxicity Surveillance During HER2-Targeted Therapy","authors":"Anthony F. Yu MD, MS , Chau T. Dang MD , Chaya S. Moskowitz PhD , Akriti Mishra Meza MS , Patricia DeFusco MD , Eric Oligino MD , Carol L. Chen MD , Rachel Sanford MD , Pamela Drullinsky MD , Jacqueline Bromberg MD, PhD , Serena Wong MD , Shanu Modi MD , Justine Jorgensen BS , Kevin C. Oeffinger MD , Richard M. Steingart MD , Jennifer E. Liu MD","doi":"10.1016/j.jaccao.2025.05.006","DOIUrl":"10.1016/j.jaccao.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Echocardiograms are recommended every 3 months to monitor for cancer therapy–related cardiac dysfunction (CTRCD) among patients treated with HER2-targeted therapy, despite increasing use of safer regimens associated with low CTRCD risk.</div></div><div><h3>Objectives</h3><div>This study evaluated the cardiac safety of reduced CTRCD surveillance performed every 6 months during non-anthracycline HER2-targeted treatment.</div></div><div><h3>Methods</h3><div>This non-randomized clinical trial enrolled 190 patients with HER2-positive breast cancer treated with non-anthracycline HER2-targeted therapy. CTRCD surveillance by means of echocardiography was performed every 6 months. Key exclusion criteria were previous anthracycline exposure, significant cardiovascular disease, and uncontrolled hypertension. The primary outcome was the cardiac event rate, defined by heart failure or cardiovascular death at 1 year. Secondary outcomes included change in LVEF from baseline to 6 months and 1 year, incidence of asymptomatic CTRCD, incidence of HER2-targeted treatment interruption, and feasibility of reduced cardiac surveillance.</div></div><div><h3>Results</h3><div>The median age was 52 years (Q1-Q3: 45-60 years); 174 (91.6%) had stage I-III disease, and all were treated with a trastuzumab-based regimen. Cardiovascular risk factors included hypertension (20.0%) and diabetes (4.2%), and the mean left ventricular ejection fraction at baseline was 63.6 ± SE 0.3%. There were 0 (0%; 1-sided 97.5% CI: 0%-1.9%) cardiac events with a median follow-up of 17.5 months (Q1-Q3: 16.3-18.9 months). One patient developed asymptomatic CTRCD (0.5%; 95% CI: 0.01%-2.9%) but resumed therapy after a temporary treatment interruption. Adherence to the reduced CTRCD surveillance schedule every 6 months was 73.2% (intention-to-treat) and 79.9% (per-protocol).</div></div><div><h3>Conclusions</h3><div>Reduced CTRCD surveillance every 6 months is safe and feasible for patients at low risk for CTRCD and may be an appropriate strategy to consider during non-anthracycline HER2-targeted treatment regimens.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 430-441"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malak El-Rayes MD , Inbar Nardi Agmon MD, MPH , Christopher Yu MBBS, PhD , Nichanan Osataphan MD, PhD , Helena A. Yu MD , Andrew Hope MD , Adrian Sacher MD , Anthony F. Yu MD, MS , Husam Abdel-Qadir MD, PhD , Paaladinesh Thavendiranathan MD, SM
{"title":"Lung Cancer and Cardiovascular Disease","authors":"Malak El-Rayes MD , Inbar Nardi Agmon MD, MPH , Christopher Yu MBBS, PhD , Nichanan Osataphan MD, PhD , Helena A. Yu MD , Andrew Hope MD , Adrian Sacher MD , Anthony F. Yu MD, MS , Husam Abdel-Qadir MD, PhD , Paaladinesh Thavendiranathan MD, SM","doi":"10.1016/j.jaccao.2025.05.003","DOIUrl":"10.1016/j.jaccao.2025.05.003","url":null,"abstract":"<div><div>Among patients with cancer, those with lung cancer have the highest prevalence of pre-existing cardiovascular disease (CVD) and the highest risk of cardiovascular events postdiagnosis. This is driven by shared risk factors, particularly smoking and socioeconomic factors, and common biology. Furthermore, multimodality therapies for lung cancer, including surgery, radiation, chemotherapy, immunotherapy, and targeted therapy, are associated with CVD. Improvements in prevention, screening, and therapy for lung cancer have led to improved cancer survival, increasing the relevance of CVD for overall survival and quality of life. This review provides an overview of lung cancer and its treatment and discusses drivers of CVD, risk assessment, surveillance, prevention, and treatment strategies.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 325-344"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vijay U. Rao MD, PhD , Anita Deswal MD, MPH , Daniel Lenihan MD , Susan Dent MD , Teresa Lopez-Fernandez MD , Alexander R. Lyon MD , Ana Barac MD, PhD , Nicolas Palaskas MD , Ming Hui Chen MD, MMSc , Hector R. Villarraga MD , Diego Sadler MD , Courtney M. Campbell MD, PhD , Kerry Skurka RN, BSN , Matt J. Wagner , Matthias Totzeck MD, PhD , Kathryn J. Ruddy MD, MPH , Paul Heidenreich MD , Randal Thomas MD , Daniel Addison MD , Sarju Ganatra MD , Joerg Herrmann MD
{"title":"Quality-of-Care Measures for Cardio-Oncology","authors":"Vijay U. Rao MD, PhD , Anita Deswal MD, MPH , Daniel Lenihan MD , Susan Dent MD , Teresa Lopez-Fernandez MD , Alexander R. Lyon MD , Ana Barac MD, PhD , Nicolas Palaskas MD , Ming Hui Chen MD, MMSc , Hector R. Villarraga MD , Diego Sadler MD , Courtney M. Campbell MD, PhD , Kerry Skurka RN, BSN , Matt J. Wagner , Matthias Totzeck MD, PhD , Kathryn J. Ruddy MD, MPH , Paul Heidenreich MD , Randal Thomas MD , Daniel Addison MD , Sarju Ganatra MD , Joerg Herrmann MD","doi":"10.1016/j.jaccao.2024.11.003","DOIUrl":"10.1016/j.jaccao.2024.11.003","url":null,"abstract":"<div><div>This document serves as a perspective on quality assessments in the discipline of cardio-oncology. We aim to define the current landscape, identify needs for quality and outcome improvements, and propose a roadmap for establishing viable metrics to improve patient care. Specifically, this document: 1) addresses the current lack of measurable high-quality metrics in cardio-oncology and their implications; 2) highlights needs and topic-specific barriers; 3) illustrates the process and application of a measurable quality metric; and 4) provides a framework to demonstrate measurable value for the growing population of patients with cancer and cardiovascular diseases.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 191-202"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Daniel BS , Moriah P. Bellissimo PhD , Ralph B. D’Agostino Jr. PhD , Kristine C. Olson PhD , Amy C. Ladd PhD , Kerryn W. Reding PhD , Kathryn E. Weaver PhD , Glenn J. Lesser MD , Bonnie Ky MD, MSCE , W. Gregory Hundley MD , UPBEAT Study Team
{"title":"Intermuscular Fat and Physical Activity Levels Relative to Exercise Capacity Change During Breast Cancer Treatment","authors":"Lauren Daniel BS , Moriah P. Bellissimo PhD , Ralph B. D’Agostino Jr. PhD , Kristine C. Olson PhD , Amy C. Ladd PhD , Kerryn W. Reding PhD , Kathryn E. Weaver PhD , Glenn J. Lesser MD , Bonnie Ky MD, MSCE , W. Gregory Hundley MD , UPBEAT Study Team","doi":"10.1016/j.jaccao.2025.01.009","DOIUrl":"10.1016/j.jaccao.2025.01.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 297-299"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlo Fumagalli MD , Adam Ioannou MBBS, BSc , Francesco Cappelli MD , Mathew S. Maurer MD , Yousuf Razvi MBChB , Aldostefano Porcari MD , Mattia Zampieri MD , Federico Perfetto MD, PhD , Muhammad U. Rauf MBBS , Ana Martinez-Naharro MD, PhD , Lucia Venneri MD, PhD , Aviva Petrie MSc , Carol Whelan MD , Ashutosh Wechalekar MD , Helen Lachmann MD , Philip N. Hawkins MD, PhD , Iacopo Olivotto MD , Raffaele Marfella MD, PhD , Andrea Ungar MD, PhD , Niccolò Marchionni MD , Marianna Fontana MD, PhD
{"title":"Clinical Phenotype and Prognostic Significance of Frailty in Transthyretin Cardiac Amyloidosis","authors":"Carlo Fumagalli MD , Adam Ioannou MBBS, BSc , Francesco Cappelli MD , Mathew S. Maurer MD , Yousuf Razvi MBChB , Aldostefano Porcari MD , Mattia Zampieri MD , Federico Perfetto MD, PhD , Muhammad U. Rauf MBBS , Ana Martinez-Naharro MD, PhD , Lucia Venneri MD, PhD , Aviva Petrie MSc , Carol Whelan MD , Ashutosh Wechalekar MD , Helen Lachmann MD , Philip N. Hawkins MD, PhD , Iacopo Olivotto MD , Raffaele Marfella MD, PhD , Andrea Ungar MD, PhD , Niccolò Marchionni MD , Marianna Fontana MD, PhD","doi":"10.1016/j.jaccao.2025.01.018","DOIUrl":"10.1016/j.jaccao.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence and clinical impact of frailty in transthyretin cardiac amyloidosis (ATTR-CA) remains poorly characterized.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the prevalence, clinical determinants, and prognostic significance of frailty in a large cohort of patients with ATTR-CA.</div></div><div><h3>Methods</h3><div>Frailty was assessed in 880 patients with ATTR-CA (median age 80 years [Q1-Q3: 75-84 years], 719 [81.7%] male) using the Clinical Frailty Scale (CFS). Frailty was analyzed as a continuous variable and categorized as CFS 1 to 3, CFS 4 or 5, CFS 6 or 7, and CFS 8 or 9.</div></div><div><h3>Results</h3><div>Frailty was observed in 502 (57.1%) patients (CFS 4 or 5: 364 [41.4%]; CFS 6 or 7: 129 [14.7%]; CFS 8 or 9: 9 [1.0%]). Independent predictors of worsening frailty included older age, female sex, non-p.(V142I) hereditary ATTR-CA variants, and National Amyloidosis Centre stage 3 disease. Mortality rates increased incrementally with frailty severity (deaths per 100 person-years: 2.9 vs 11.0 vs 21.1 vs 40.9; log-rank <em>P</em> < 0.001). Frailty was independently associated with higher mortality risk across all age groups, genotypes, and disease stages.</div></div><div><h3>Conclusions</h3><div>Frailty is common in ATTR-CA and is independently linked to increased mortality risk. Incorporating frailty assessment alongside traditional markers enhances prognostication across genotypes and disease severities, particularly for short-term risk estimation.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 268-278"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}