Cardio-oncology最新文献

{"title":"Real-world data of cardio-oncologic interventions for cardiovascular adverse events with oral oncolytics","authors":"Karen Abboud, G. Umoru, Barry Trachtenberg, Veronica Ajewole","doi":"10.1186/s40959-024-00221-5","DOIUrl":"https://doi.org/10.1186/s40959-024-00221-5","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140727290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac markers in left-sided breast cancer patients receiving adjuvant radiotherapy: a prospective study","authors":"K. Chufal, Irfan Ahmad, Anuj Prakash, Alexis Miller, P. Umesh, Varsha Koul, Ram Bajpai, Bharat Dua, Priya Gupta, M. Gairola","doi":"10.1186/s40959-024-00225-1","DOIUrl":"https://doi.org/10.1186/s40959-024-00225-1","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive pediatric cardio-oncology program: a single institution approach to cardiovascular care for pediatric patients with cancer and childhood cancer survivors","authors":"N. B. Hernandez, K. Shliakhtsitsava, Drishti Tolani, Cindy Cochran, Ryan Butts, Judith Bonifacio, Elizabeth Journey, Jenna N. Oppenheim, Sarah G. Pennant, Kimberly Arnold, Terri McCaskill, Daniel C. Bowers","doi":"10.1186/s40959-024-00211-7","DOIUrl":"https://doi.org/10.1186/s40959-024-00211-7","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term cardiac effects of modern treatment for Hodgkin’s lymphoma","authors":"A. W. Bjerring, Knut HB Smeland, Thomas Stokke, K. Haugaa, E. Holte, Assami Rösner, C. Kiserud, T. Edvardsen, S. Sarvari","doi":"10.1186/s40959-024-00222-4","DOIUrl":"https://doi.org/10.1186/s40959-024-00222-4","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation and acute cardiotoxicity in adult hematological patients treated with CAR-T cells: results from a pilot proof-of-concept study.","authors":"Massimiliano Camilli, Marcello Viscovo, Tamara Felici, Luca Maggio, Federico Ballacci, Giacomo Carella, Alice Bonanni, Priscilla Lamendola, Lorenzo Tinti, Antonio Di Renzo, Giulia Coarelli, Eugenio Galli, Giovanna Liuzzo, Francesco Burzotta, Rocco Antonio Montone, Federica Sorà, Simona Sica, Stefan Hohaus, Gaetano Antonio Lanza, Filippo Crea, Antonella Lombardo, Giorgio Minotti","doi":"10.1186/s40959-024-00218-0","DOIUrl":"10.1186/s40959-024-00218-0","url":null,"abstract":"<p><strong>Aims: </strong>Chimeric Antigen Receptor-T (CAR-T) cell infusion is a rapidly evolving antitumor therapy; however, cardiovascular (CV) complications, likely associated with cytokine release syndrome (CRS) and systemic inflammation, have been reported to occur. The CARdio-Tox study aimed at elucidating incidence and determinants of cardiotoxicity related to CAR-T cell therapy.</p><p><strong>Methods: </strong>Patients with blood malignancies candidate to CAR-T cells were prospectively evaluated by echocardiography at baseline and 7 and 30 days after infusion. The study endpoints were i) incidence of cancer therapy-related cardiac dysfunction (CTRCD), CTRCD were also balanced for any grade CRS, but CTRCD occurred of Cardiology Guidelines on Cardio-Oncology (decrements of left ventricular ejection fraction (LVEF) or global longitudinal strain (GLS) and/or elevations of cardiac biomarkers (high sensitivity troponin I, natriuretic peptides) and ii), correlations of echocardiographic metrics with inflammatory biomarkers.</p><p><strong>Results: </strong>Incidence of CTRCD was high at 7 days (59,3%), particularly in subjects with CRS. The integrated definition of CTRCD allowed the identification of the majority of cases (50%). Moreover, early LVEF and GLS decrements were inversely correlated with fibrinogen and interleukin-2 receptor levels (p always ≤ 0.01).</p><p><strong>Conclusions: </strong>There is a high incidence of early CTRCD in patients treated with CAR-T cells, and a link between CTRCD and inflammation can be demonstrated. Dedicated patient monitoring protocols are advised.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10967131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140292903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the effects of various β-blockers on cardiovascular mortality in breast cancer patients.","authors":"Mantasha Tabassum, Soumya G Chikermane, Camille Johnson, Noor M Abdulkareem, Elisabeth M Wang, Michael L Johnson, Meghana V Trivedi","doi":"10.1186/s40959-024-00217-1","DOIUrl":"10.1186/s40959-024-00217-1","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular (CV) disease is a leading cause of death in breast cancer (BC) patients due to the increased age and treatments. While individual β-blockers have been investigated to manage CV complications, various β-blockers have not been compared for their effects on CV death in this population. We aimed to compare CV mortality in older BC patients taking one of the commonly used β-blockers.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results (SEER) - Medicare data (2010-2015). Patients of age 66 years or older at BC diagnosis receiving metoprolol, atenolol, or carvedilol monotherapy were included. The competing risk regression model was used to determine the risk of CV mortality in the three β-blocker groups. The multivariable model was adjusted for demographic and clinical covariates. The adjusted hazard ratio (HR) and 95% confidence intervals (CI) were reported for the risk of CV mortality.</p><p><strong>Results: </strong>The study cohort included 6,540 patients of which 55% were metoprolol users, 30% were atenolol users, and 15% were carvedilol users. Metoprolol was associated with a 37% reduced risk of CV mortality (P = 0.03) compared to carvedilol after adjusting for the covariates (HR = 0.63; 95% CI 0.41-0.96). No significant difference in the risk of CV mortality between atenolol and carvedilol users was observed (HR = 0.74; 95% CI 0.44-1.22).</p><p><strong>Conclusions: </strong>Our findings suggest that metoprolol is associated with a reduced risk of CV mortality in BC patients. Future studies are needed to confirm these findings and understand the mechanism of action.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140292949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trastuzumab in patients with breast cancer and pre-existing left ventricular systolic dysfunction.","authors":"Azin Alizadehasl, Mina Mohseni, Kamran Roudini, Parisa Firoozbakhsh","doi":"10.1186/s40959-024-00220-6","DOIUrl":"10.1186/s40959-024-00220-6","url":null,"abstract":"<p><strong>Background: </strong>Trastuzumab is one of the most effective treatments in HER-2 positive breast cancer patients. However, it is associated with development of cardiomyopathy/heart failure (HF) which is often a limiting side effect and associated with overall adverse outcomes. As a result, patients with pre-existing LV systolic dysfunction (LVSD) are often excluded from receiving anti-HER-2 therapy, which may lead to less effective cancer treatment and worse prognosis.</p><p><strong>Objectives: </strong>The current study aims to evaluate the safety of trastuzumab in patients with HER-2 positive breast cancer and pre-existing LVSD.</p><p><strong>Methods: </strong>In this retrospective cohort study, 36 consecutive patients at a single center in Iran with HER-2 positive breast cancer with asymptomatic mild LVSD with LVEF 40-53% without heart failure symptoms and those who were closely followed in the Cardio-Oncology clinic before initiating the treatment and then every two cycles of trastuzumab were included. As per the program standard protocol they received a beta-blocker (carvedilol) and ACE-I (Lisinopril), up to the maximum tolerated dose, if there were no contraindications. Patients underwent routine echocardiography with global longitudinal strain (GLS) assessment every 3 months per guideline recommendations and were followed up 6 months after the end of treatment. Primary composite outcomes included myocardial infarction (MI), cardiac arrhythmia, heart failure(HF) symptoms and cardiovascular death. Secondary outcome was ≥ 10% reduction in LVEF or ≥ 15% reduction in GLS compared to baseline. If the LVEF decreased below 40%, the treatment was temporarily interrupted for one or two cycles, and spironolactone was added to the patient's treatment. If the LVEF improved ≥ 40%, trastuzumab was rechallenged. Data analysis was performed using IBM SPSS Statistics 24.0. Software. Patients' characteristics were reported using descriptive statistics, and its association with drop in LVEF or GLS was assessed using Pearson chi-square or Mann-Whitney U test. A p-value of less than 0.05 was considered significant.</p><p><strong>Results: </strong>Thirty-six patients were included in the study. Primary composite outcome was noted in 1(2.8%) patient. LVEF reduction of ≥ 10% occurred in 6(16.7%) of the patients, and a GLS reduction of more than 15% was detected in 4 (11.1%) of the patients. There was a significant association between a ≥ 10% reduction in LVEF and baseline systolic blood pressure (P-value: 0.04). LVEF reduction below 40% was observed in 3 (8.3%) patients, where trastuzumab was interrupted. All of these three patients had obesity (Median BMI 34.11, IQR 9.12) and uncontrolled HTN, and one of them had symptoms of heart failure (NYHA class II), for whom the trastuzumab treatment was discontinued. Among two patients, after the temporary interruption of trastuzumab, and addition of spironolactone, LVEF improved to above 40%, and the treatment","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early reduction in cardiorespiratory fitness and diastolic reserve following radiation therapy for lung cancer.","authors":"Georgia Thomas, Elisabeth Weiss, Marco Giuseppe Del Buono, Francesco Moroni, Josh West, Rachel Myers, Emily Kontos, Michele Golino, Antonio Abbate, Justin M Canada","doi":"10.1186/s40959-024-00216-2","DOIUrl":"10.1186/s40959-024-00216-2","url":null,"abstract":"<p><strong>Background: </strong>Contemporary radiotherapy for the treatment of lung cancer is effective in targeting tumor tissue while limiting heart exposure, yet cardiac toxicity still occurs, often becoming clinically apparent years later. Cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular, cancer-related, and overall mortality and may serve as a sensitive measure of subclinical cardiac toxicity following anti-cancer treatments. Prior work has demonstrated a significant relationship between reduced CRF and impaired left-ventricular (LV) diastolic reserve in cancer survivors following thoracic radiotherapy. The purpose of this study was to assess early longitudinal changes in CRF and cardiac function in patients with lung cancer following radiotherapy.</p><p><strong>Methods: </strong>Ten patients (69 [61-76] years, 70% female) with lung cancer without known cardiovascular disease scheduled to receive radiotherapy involving a clinically-relevant heart dose (≥ 5 Gy to > 10% of heart volume) were evaluated prior to and following treatment. Changes in CRF (peak oxygen consumption [VO_2peak], oxygen uptake efficiency slope [OUES]), cardiac function (LV ejection fraction [LVEF], rest and exercise diastolic function [diastolic functional reserve index (DFRI)]), cardiac biomarkers (N-terminal pro-brain natriuretic peptide [NT-proBNP], high-sensitivity C-reactive protein [hsCRP]), and health-related quality of life (HRQOL; Functional Assessment of Cancer Therapy-General-7 [FACT-G7]) were measured.</p><p><strong>Results: </strong>The VO_2peak was reduced at baseline (1.245 [0.882-1.605] L·min^- 1; 70 [62-86] %-predicted) and significantly declined (1.095 [0.810-1.448] L·min^- 1, P = 0.047; 62 [56-76] %-predicted, P = 0.005) at 6.0 [3.0-6.0] months post-radiotherapy. Similarly, a significant decline in the OUES was observed (1.63 [1.27-1.88] to 1.57 [1.12-1.75], P = 0.032). Systolic cardiac function was normal at baseline and did not change following radiotherapy (LVEF; 62 [56-65]% to 66 [57-68]%, P = 0.475). The DFRI significantly declined following radiotherapy (34.9 [22.7-41.6] vs. 12.8 [3.1-35.9]). The hsCRP increased significantly from 4.4 [1.4-5.8] to 6.1 [3.7-20.7] g/L, P = 0.047 with a trend towards higher levels of NT-proBNP (65 [49-125] to 121 [88-191] pg/mL, P = 0.110). Health-related quality of life significantly decreased (FACT-G7; 21.5 [18.8-25] to 15.5 [11.5-20]; P = 0.021) post-radiotherapy.</p><p><strong>Conclusions: </strong>Patients with lung cancer receiving radiotherapy with a clinically-significant heart dose experience reductions in CRF (VO_2peak, OUES) as early as six months following treatment with concurrent reductions in diastolic reserve (DFRI), HRQOL, and increases in cardiac biomarkers (NT-proBNP, hsCRP).</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late cardiotoxicity related to HER2-targeted cancer therapy.","authors":"Isabelle Senechal, Maria Sol Andres, Jieli Tong, Ylenia Perone, Sivatharshini Ramalingam, Muhummad Sohaib Nazir, Stuart D Rosen, Nicholas Turner, Alistair Ring, Alexander R Lyon","doi":"10.1186/s40959-024-00215-3","DOIUrl":"10.1186/s40959-024-00215-3","url":null,"abstract":"<p><p>Long-term anti-HER2 therapy in metastatic HER2 + cancers is increasing, but data about the incidence and risk factors for developing late Cancer therapy-related cardiac dysfunction (CTRCD) are missing. We conducted a single-centre, retrospective analysis of a cohort of late anti-HER2 related cardiac dysfunction referred to our Cardio-Oncology service. We include seventeen patients with metastatic disease who developed CTRCD after at least five years of continuous anti-HER2 therapy. Events occurred after a median time of 6.5 years (IQR 5.3-9.0) on anti-HER2 therapy. The lowest (median) LVEF and GLS were 49% (IQR 45-55) and - 15.4% (IQR - 14.9 - -16.3) respectively. All our patients continued or restarted, after a brief interruption, their anti-HER2 therapy. Most (16/17) were started on heart failure medical therapy and normalized their left ventricular ejection fraction at a follow-up. Our study has demonstrated that CTRCD can occur after many years of stability on anti-HER2 therapy and reinforces the importance of continuing cardiovascular surveillance in this population.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140058765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-dimensional speckle tracking echocardiography in chemotherapy-induced cardiotoxicity in females with breast cancer.","authors":"Ahmed A Fawzy, Khaled A El-Menyawi, Walid M Sallam, Mohamed E Zahran","doi":"10.1186/s40959-024-00209-1","DOIUrl":"10.1186/s40959-024-00209-1","url":null,"abstract":"<p><strong>Background: </strong>Cancer and cardiovascular diseases are the main causes of mortality worldwide. Although the incidence of cancer is rising, modern comprehensive management including surgery, chemotherapy, and radiotherapy led to decreased mortality, but also different cardiovascular complications. Conventional EF measurement fails to detect subtle changes in LV function, so a more sensitive tool is needed.</p><p><strong>Methods: </strong>The study included 101 asymptomatic female patients with newly diagnosed breast cancer who received anthracycline ± trastuzumab-based chemotherapy regimen. A comprehensive echocardiographic examination was performed before receiving the chemotherapy (T0), at 3 months (T1), and at 6 months after (T2). All patients had pre-treatment normal LV EF. Asymptomatic CTRCD is defined as: severe if new LVEF reduction to < 40%, moderate if new LVEF reduction by ≥ 10 percentage points to an LVEF of 40-49% or new LVEF reduction by, 10 percentage points to an LVEF of 40- 49% and either new relative decline in GLS by .15% from baseline or new rise in cardiac biomarkers and mild if LVEF ≥ 50% and new relative decline in GLS by .15% from baseline and/or new rise in cardiac biomarkers. Symptomatic CTRCD is defined as: very severe if HF requiring inotropic support, mechanical circulatory support, or consideration of transplantation, severe if required hospitalization, moderate if required outpatient intensification of diuretic and HF therapy and mild if there are mild HF symptoms and no intensification of therapy required according to the latest ESC cardio oncology guidelines. The Lower reference value set for RV S' was less than 10cm/s to define RV systolic dysfunction according to ASE guidelines.</p><p><strong>Results: </strong>CTRCD occurred in 24 patients (25.5%) while RV systolic dysfunction was more common occurring in 37 patients (39.4%). LV GLS at (T1) (cut-off value < -15% with relative 12.5% reduction from the baseline value) was a strong predictor of CTRCD, but combining LV GLS with RV GLS & RV FWLS was the strongest (AUC = 0.947, sensitivity = 91.67%, specificity = 90%).</p><p><strong>Conclusion: </strong>Chemotherapy induces biventricular changes with more prevalent deterioration in RV values. Low LV & RV strain values at baseline together with reduction of these values after chemotherapy treatment can predict later CTRCD development. Combining LV GLS with RV GLS & FWLS values at (T1) is the strongest predictor of subsequent CTRCD.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10905860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}