Cardio-oncology最新文献

{"title":"Anticoagulation challenges in cancer patients: prevention, detection, and treatment strategies.","authors":"Simona Chiusolo, Chelsea Kriesberg, Eric Oligino, Avirup Guha, Husam Abdel-Qadir, Joseph Carver, Stephen Casselli, Daniel Lenihan","doi":"10.1186/s40959-026-00473-3","DOIUrl":"10.1186/s40959-026-00473-3","url":null,"abstract":"<p><p>Cancer-associated thrombosis is one of the most common and serious complications in oncology patients, contributing significantly to morbidity and mortality. This prothrombotic state is driven by cancer-related factors, systemic inflammation, and treatment-induced endothelial injury. Anticoagulation management in these patients is challenging, as both thrombotic and bleeding risks must be carefully balanced, particularly in those with cardiovascular comorbidities. This review examines the complexities of anticoagulation in cancer-associated thrombosis through three clinical cases. Case 1 focuses on thrombosis associated with central venous catheters, exploring prevention strategies and therapeutic approaches. Case 2 discusses the management of venous thromboembolism in metastatic prostate cancer with concurrent cardiovascular disease, emphasizing the challenges of overlapping arterial and venous risks. Case 3 highlights the interplay between immune checkpoint inhibitors and postoperative atrial fibrillation in a patient with non-small cell lung cancer, exploring immune-mediated mechanisms and their implications for anticoagulation. The review also discusses advances in risk stratification tools, detection methods, and emerging therapies such as FXI inhibitors. Effective management of anticoagulation in cancer patients requires personalized strategies that consider cancer-specific risks, treatment-related factors, and comorbidities. Advances in biomarkers, predictive models, and innovative therapies hold promise for improving outcomes in this high-risk population.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763687","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":"The state of cardio-oncology in Oman: awareness, practices, and training needs among healthcare providers: a survey-based study.","authors":"Ahmed Basuoni, Bushra Salman, Khalid Al-Baimani, Suhaila Al Farsi, Waleed Dawelbeit, Mohamed Barakat Al Riyami, Marwa Ahmed Makhlouf, Issa Al Qarshoubi, Adil Barakat Al Riyami, Mohamed Najeeb Al Rawahi","doi":"10.1186/s40959-026-00492-0","DOIUrl":"10.1186/s40959-026-00492-0","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Cardio-oncology has emerged as a multidisciplinary subspecialty to address the growing burden of cancer therapy–related cardiovascular toxicity and its impact on morbidity and mortality. However, data on awareness, practice patterns, and service availability remain limited. This study aimed to evaluate awareness, clinical practices and service availability related to cardio-oncology among healthcare providers (HCPs) in Oman. METHODS: We conducted a national, cross-sectional, survey-based study among physicians and clinical pharmacists practicing in Oman between April and December 2025. The structured questionnaire, adapted from previously validated international surveys, assessed awareness of cardio-oncology, availability of services, clinical practices, training exposure, and decision-making using two standardized cardiotoxicity case scenarios. RESULTS: Of 437 invited participants, 124/167 completed the survey. Respondents included cardiologists (n = 48, 38.7%), internal medicine physicians (n = 39, 31.5%), oncologists (n = 23, 18.5%), and clinical pharmacists (n = 14, 11.3%), with the majority practicing in tertiary centers (n = 76, 61.3%). Formal training in cardio-oncology was rare (n = 4, 3.6%). Overall awareness of cardio-oncology was moderate to high. Most participants recognized key domains, including management of cancer therapy–related cardiac complications (n = 109, 88.0%), identification of cardiotoxicity and referral (n = 106, 86.0%), and risk stratification (n = 105, 85.0%). However, awareness was lower for survivorship care (n = 77, 62.0%) and patient education (n = 72, 58.0%). Composite awareness was observed in 64% (≥ 3 domains) and 51% (all domains), with significantly higher awareness in tertiary centers compared to secondary settings (57.9% vs. 18.8%, p &lt; 0.001). Cardio-oncology services were limited: 35% reported general cardiology-led care, while only 17.9% reported access to specialized services; 33.3% were uncertain about service availability. Major barriers included limited funding and infrastructure. Most respondents emphasized the importance of cardiotoxicity assessment during cancer care (very important: 74.4% pre-treatment, 75.6% during treatment). While 50.6% supported routine cardiology monitoring even in low-risk patients, practices regarding cardioprotective therapy varied. The majority (78.3%) believed that access to cardio-oncology services would significantly improve patient outcomes. Cardiologists reported significantly higher confidence and more consistent management of cardiotoxicity than oncologists (p &lt; 0.05). CONCLUSIONS: Although healthcare providers in Oman demonstrate moderate awareness of cardio-oncology, significant gaps remain in structured training, service availability, and survivorship-focused care. Establishing dedicated multidisciplinary cardio-oncology programs and targeted educational initiatives is essential to bridge the gap between knowledge and clinical implementation an","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763848","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":"Sacubitril/valsartan for the prevention of cancer therapy-related cardiac dysfunction: a systematic review and meta-analysis.","authors":"Yee-Jen Wu, Hung-Ju Lin, Yi-Hsin Hung, Che-Wei Liao, Yen-Hung Lin, Chi-Sheng Hung","doi":"10.1186/s40959-026-00494-y","DOIUrl":"10.1186/s40959-026-00494-y","url":null,"abstract":"<p><p>INTRODUCTION: Sacubitril/valsartan is being investigated for cardiac protection during cancer therapy. However, evidence regarding its preventive effect on cancer therapy–related cardiac dysfunction (CTRCD) remains inconsistent. AIMS: To evaluate the efficacy and safety of sacubitril/valsartan for the prevention of CTRCD during oncologic therapy. METHODS AND RESULTS: We searched PubMed, EMBASE, and Web of Science for randomized controlled trials (RCTs) comparing sacubitril/valsartan with control for the prevention of CTRCD during oncologic therapy, with treatment effects synthesized using risk ratio (RR), mean differences (MD), or standardized mean differences (SMD) with 95% confidence intervals. Four RCTs involving 410 participants were included. Sacubitril/valsartan reduced the absolute risk of CTRCD compared with control (RR 0.66, 95% CI 0.53 to 0.82, p < 0.001). Sacubitril/valsartan was associated with a significant improvement in left ventricular ejection fraction (MD 1.19%, 95% CI 0.05 to 2.33, p = 0.045), global longitudinal strain (SMD 0.43, 95% CI 0.10 to 0.75, p = 0.026), and a reduction in troponin (log-MD − 0.43, 95% CI − 0.59 to − 0.26, p < 0.001), compared with the control group. Sacubitril/valsartan increased the risk of hypotension (RR 4.75, 95% CI 1.78 to 12.63, p = 0.002). No significant differences were observed in left ventricular volume, work indices, or NT-proBNP levels. Trial sequential analysis indicated that the current evidence remains insufficient to draw firm conclusions regarding the effect of cardioprotection on CTRCD. CONCLUSION: Sacubitril/valsartan may be associated with modest reductions in CTRCD risk and attenuation of LVEF and GLS decline in patients with preserved baseline cardiac function receiving chemotherapy. However, the clinical relevance remains inconclusive when considering the trial sequential analysis and the modest magnitude of effect. These findings are primarily hypothesis-generating rather than practice-changing, and require confirmation in larger randomized trials, particularly in higher-risk populations. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763700","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":"Entrectinib results in ventricular tachycardia and Brugada phenocopy through inhibition of sodium current.","authors":"Matthew R Fleming, Tao Yang, John A Wells, Kathryn I Sunthankar, Teresa L Strickland, Marcia A Blair, Travis D Richardson, Eiman Jahangir, Bjorn C Knollmann, Dan M Roden","doi":"10.1186/s40959-026-00485-z","DOIUrl":"10.1186/s40959-026-00485-z","url":null,"abstract":"<p><p>BACKGROUND: Entrectinib is a tropomyosin receptor kinase (TrK) inhibitor currently approved for the treatment of ROS1-positive non-small cell lung cancer (NSCLC) and neurotrophic tyrosine receptor kinase (NTRK) gene fusion-positive solid tumors. Two case reports of ventricular tachycardia and a Brugada ECG pattern following entrectinib treatment have been published, and we observed a third case in our clinical practice. Genetic testing on the patient showed no variants in SCN5A. OBJECTIVE: To determine if entrectinib treatment of human cardiomyocytes results in alterations in sodium currents, which may lead to Brugada phenocopy and ventricular tachycardia. METHODS: Studies were performed in human ventricular cardiomyocytes (hiPSC-vCMs) derived from population-control induced pluripotent stem cells. hiPSC-vCMs were treated with entrectinib (1 µM) for either a brief (15 min) or prolonged exposure (48 h) prior to experimental analysis. RESULTS: Treatment of hiPSC-vCMs with entrectinib (1 µM) for 48 h resulted in a significant decrease in sodium currents during channel activation and inactivation. Treatment with entrectinib for 15 min did not significantly change sodium currents. Western blot analysis revealed no changes in NaV1.5 protein expression after 48 h of entrectinib treatment. CONCLUSION: Prolonged treatment with entrectinib decreased sodium currents in hiPSC-vCMs, which may lead to Brugada phenocopy and ventricular arrhythmias. Brief treatment with entrectinib did not affect sodium currents, and no changes in NaV1.5 protein expression were observed following prolonged treatment, indicating that inhibition of sodium currents likely results through a phospho-signaling mechanism rather than by direct channel inhibition. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763851","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":"Evaluating the impact of Lutetium-177 therapy on bioprosthetic heart valves in carcinoid heart disease.","authors":"Isabel G Scalia, Fatmaelzahraa E Abdelfattah, Juan M Farina, Omar H Ibrahim, Kamal Awad, Juan A Crestanello, Hartzell V Schaff, Thorvardur R Halfdanarson, Jordan C Ray, Patricia A Pellikka, Heidi M Connolly, Reza Arsanjani, Chadi Ayoub","doi":"10.1186/s40959-026-00496-w","DOIUrl":"10.1186/s40959-026-00496-w","url":null,"abstract":"<p><p>BACKGROUND: Severe carcinoid heart disease (CaHD) may require bioprosthetic valve (BPV) replacement. Lutetium-177 (Lu-177) DOTATATE is increasingly utilized in patients with neuroendocrine tumors (NETs); however, its effect on BPVs remains unknown. METHODS: A retrospective review of patients with CaHD who underwent BPV replacement at three tertiary centers in the United States was conducted. Patients were stratified by Lu-177 DOTATATE therapy with a propensity-matched non-exposed cohort. BPV degeneration and mortality were compared. RESULTS: Of 183 patients with CaHD and BPV replacement (median age 62.9 years, 50.8% male), 27 received Lu-177 DOTATATE (16 postoperatively, 11 preoperatively). BPVs treated with Lu-177 DOTATATE postoperatively demonstrated increased BPV degeneration (HR 4.42, 95%CI 3.29–5.93, p < 0.001). BPVs in patients preoperatively exposed to Lu-177 DOTATATE showed no difference in degeneration. There was no difference in mortality in those treated or not treated with Lu-177 DOTATATE. CONCLUSIONS: Our findings suggest an association between postoperative Lu-177 DOTATATE and increased BPV degeneration in CaHD patients. Where feasible, therapy prior to valve replacement should be considered. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721848","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":"Chemotherapy-responsive primary cardiac lymphoma presenting as pericarditis and acute heart failure.","authors":"Meghan Schilthuis, Benjamin Fischer, Shanelle De Lancy, Ryan Stohler, Utpal P Davé","doi":"10.1186/s40959-026-00487-x","DOIUrl":"10.1186/s40959-026-00487-x","url":null,"abstract":"<p><p>BACKGROUND: Primary cardiac lymphomas (PCLs) are a rare subset of malignancies, representing a very small percentage of reported cancer patients. Even among primary cardiac tumors a diagnosis of lymphoma is rare, making a standard of care difficult to establish. CASE PRESENTATION: Here we report the case of a patient who presented with chest pain and dyspnea who was initially diagnosed with pericarditis. Further imaging revealed a large obstructive right atrial mass with pathologic diagnosis of aggressive B-cell lymphoma. The patient was initiated on multiagent chemotherapy with daEPOCH-R comprising etoposide, prednisone, cyclophosphamide, vincristine, and rituximab with subsequent improvement in heart failure symptoms and tumor markers. Doxorubicin was added upon normalization of ejection fraction. The patient developed central nervous system relapse three months after completion of chemotherapy. CONCLUSIONS: This case describes the diagnostic evaluation and treatment of a patient with primary cardiac lymphoma. In contrast to other cardiac tumors, most patients with PCLs are treated with chemotherapy alone. Despite this, mortality remains high. When aggressive tumor biology is present, rapid initiation of high intensity chemotherapy is feasible. Our patient showed rapid clinical improvement and resolution of his cardiac mass in response to the daEPOCH-R regimen. This case illustrates the value of a multidisciplinary approach to establish a rare diagnosis and initiate prompt treatment for an unstable patient. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716104","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":"Exploring healthcare professionals' experiences and perceptions of self-management of cancer therapy-induced cardiotoxicity in breast cancer survivors: a qualitative study.","authors":"Xianliang Liu, Mubei Yang, Yuhua Ma, Qiaohong Yang","doi":"10.1186/s40959-026-00488-w","DOIUrl":"10.1186/s40959-026-00488-w","url":null,"abstract":"<p><p>OBJECTIVE: Advancements in cancer treatments have significantly improved survival rates for breast cancer (BC) patients; however, these treatments are often accompanied by severe adverse effects, such as cardiotoxicity. Effective patient-centred self-management plays a critical role in the early detection of cardiotoxic symptoms and in enhancing BC survivors’ overall quality of life. To support this process, education and ongoing support from healthcare professionals is essential. This study aimed to explore healthcare professionals’ experiences and perspectives in facilitating BC survivors’ self-management of cancer therapy-induced cardiotoxicity. METHODS: This study employed a fundamental qualitative descriptive approach. Semi-structured interviews were conducted with healthcare professionals from a BC department in Guangzhou, China. Audio recordings were transcribed and analysed using NVivo 12 software. Thematic analysis was also conducted. FINDINGS: Thirteen participants – including doctors, nurses, and a case manager – were recruited. The participants’ working experience ranged from two to 30 years. Three themes and six subthemes were identified: (1) healthcare professionals’ understanding of cancer therapy-induced cardiotoxicity and the importance of patients’ self-management of its symptoms; (2) strategies for supporting self-management; and (3) barriers and challenges to effective self-management, such as inefficient communication, low patient adherence, inadequate cross-departmental collaboration, and an outdated clinical system. Many of the participants relied more on pharmacological interventions than on empowering patients’ self-management skills. CONCLUSIONS: Despite healthcare professionals recognising the value of patients’ self-management of symptoms, multiple barriers hinder its implementation. Participants highlighted the need for more accessible, structured patient education approaches, as well as improvements to clinical information systems to better support ongoing monitoring and communication. Strengthening interdisciplinary collaboration and enhancing healthcare professionals’ training in self-management support were also identified as priorities for improving comprehensive cardio-oncology care. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688452","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":"Disease burden of ATTR amyloidosis based on the SF-36^® health survey.","authors":"Vaishali Sanchorawala, Alexandra Greatsinger, Andrew Staron, John L Berk, Lisa M Mendelson, Tracy Joshi, Natasha J Burke, Nadia Tabatabaeepour, Jess Smith, James Signorovitch","doi":"10.1186/s40959-026-00482-2","DOIUrl":"10.1186/s40959-026-00482-2","url":null,"abstract":"<p><p>Transthyretin (ATTR) amyloidosis is a progressive systemic disease associated with substantial morbidity and mortality. Although health-related quality of life (HRQoL) assessments are increasingly incorporated into clinical trials, data in ATTR amyloidosis remain limited. We conducted a retrospective observational study of patients with confirmed ATTR amyloidosis evaluated at the Boston University Amyloidosis Center between 1992 and 2022. Patients who completed the 36-Item Short Form Health Survey (SF-36®) at baseline were included. Participants were categorized as wild-type ATTR (ATTRwt), V122I-variant ATTR (V122I-ATTRv), or non-V122I-ATTRv. SF-36® domain scores were summarized into norm-based Physical Component Summary (PCS) and Mental Component Summary (MCS) scores (U.S. population mean 50, SD 10).Among 997 patients evaluated, 836 (83.9%) completed the SF-36®. Of these, 407 (48.7%) had ATTRwt, 336 (40.2%) non-V122I-ATTRv, and 93 (11.1%) V122I-ATTRv. Mean age was 66.9 years, ranging from 55.8 years in non-V122I-ATTRv to 75.3 years in ATTRwt. The V122I-ATTRv cohort was predominantly Black (91.4%). PCS scores were markedly reduced across all groups compared with population norms, with the greatest impairment in V122I-ATTRv (33 ± 11), followed by ATTRwt (36 ± 11) and non-V122I-ATTRv (37 ± 13). The most affected domains were role limitations due to physical health and vitality. In contrast, MCS scores were near population averages across all groups (49–51), suggesting preserved mental and social well-being.ATTR amyloidosis is associated with substantial physical HRQoL impairment, particularly in patients with the V122I variant, comparable to chronic heart failure. These findings suggest the importance of routine HRQoL assessment and support the development of amyloidosis-specific patient-reported outcome measures.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688586","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":"The pulmonary artery hypertension and cancer: PULAHYCA PILOT study. Initial prostanoid therapy in cancer patients with pulmonary hypertension: results from an observational study.","authors":"Vanesa Gregorietti, Teresa López-Fernández, Joerg Herrmann, Diego Costa, Andrés J Daniele","doi":"10.1186/s40959-026-00477-z","DOIUrl":"10.1186/s40959-026-00477-z","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Cancer is a leading cause of death worldwide, though new therapies have increased patient survival. These therapies, however, have also raised concerns for cardiovascular toxicities, such as cardiomyopathies, coronary artery disease, hypertension and arrhythmias. Pulmonary arterial hypertension (PAH) is a rare condition that carries a poor prognosis and is often diagnosed at an advanced stage. The annual incidence in the general population is estimated to be between 1 and 2 cases per million. The highest prevalence occurs during the third and fourth decades of life; however, there are cases whose are identified after the sixth decade. It has increasingly become evident that various cancer therapies can exacerbate pulmonary hypertension, significantly impacting patient prognosis. It is recognized that oncologic treatments can cause endothelial dysfunction, including the pulmonary vasculature, and can have thrombotic effects, worsening PAH in patients with this disease. The objective of this study is to describe our experience with patients with a concomitant diagnosis of PAH and cancer, who received prostanoid therapy to be able to complete specific cancer treatments. METHODS: The PULmonary Artery HYpertension and Cancer (PULAHYCA) pilot study is an observational study of patients with a cancer diagnosis planning to initiate a specific oncologic treatment, with PAH detected during baseline assessment. Patients with PAH due to group 1and group 4 were included, defined as per the 2022 European Society of Cardiology (ESC) guidelines, that require a mean pulmonary artery pressure (mPAP) greater than 20 mm Hg at rest, increased pulmonary artery resistance of more than 2 Wood units and wedge pressure less than 15 mm Hg. The PAH risk category was established according to the ESC guidelines and the REVEAL Lite 2 score. Patients with an intermediate risk with a diagnosis of more than 6 months were included. RESULTS: After screening 349 PH patients, 12 patients were included in the study. All participants had a normal ejection fraction and were treated with a combination of a 5- phosphodiesterase inhibitor, an endothelin receptor antagonist, and treprostinil. Eight patients were classified under group 1 pulmonary hypertension, and four under group 4 pulmonary hypertension. During the 12-month follow-up, patients demonstrated significant clinical and hemodynamic improvement. Functional capacity, measured by the six-minute walk test (6MWT), increased significantly from 325 [304–440] meters at baseline to 401 [315–455] meters at 12 months (p = 0.0014). B-type natriuretic peptide (BNP) levels decreased notably from 321 [205–506] pg/ml to 188 [100–229] pg/ml (p = 0.0001). Pulmonary vascular resistance (PVR) also showed a significant reduction, from 3.8 [3.3–4.2] Woods Units (WU) to 3.5[2.5–3.7] WU (p = 0.00018). All patients survived during the study period and could complete their cancer treatment, which included. CONCLUSION: The PULAHYCA PILO","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688484","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":"Review on cardioprotective strategies in the setting of chemotherapy-induced cardiotoxicity.","authors":"Vinh Dao, Shray Amin, Thirumala Kammaripalle, Kenneth Manning","doi":"10.1186/s40959-026-00480-4","DOIUrl":"10.1186/s40959-026-00480-4","url":null,"abstract":"<p><p>BACKGROUND: Chemotherapy-induced cardiotoxicity represents a major challenge in the care of cancer patients, particularly with anthracyclines, HER2-directed therapies, and other cytotoxic agents. As cancer survival improves, preserving cardiovascular health has become increasingly important. OBJECTIVE: This review summarizes current evidence on pharmacologic, non-pharmacologic, and novel drug-delivery strategies for preventing and managing CIC, with a focus on optimizing left ventricular function. METHODS: A comprehensive literature search of PubMed identified randomized controlled trials, observational studies, systematic reviews, and meta-analyses evaluating cardioprotective strategies in adults receiving cardiotoxic chemotherapy. Outcomes included left ventricular ejection fraction (LVEF), heart failure incidence, troponin levels, and global longitudinal strain (GLS). RESULTS: Pharmacologic strategies with the strongest evidence include dexrazoxane and liposomal encapsulation of anthracyclines. Beta-blockers, ACE inhibitors, ARBs, MRAs, and statins to non-pharmacologic interventions like structured exercise programs and echocardiographic surveillance with GLS provide varying degrees of support. Still, the current literature is marked by heterogeneity in study design, endpoints, and patient populations. Other potential pharmacologic interventions include SGLT2 inhibitors and GLP-1 RA. While meta-analyses often show favorable trends, large-scale randomized controlled trials remain essential to validate these approaches, optimize patient selection, and standardize implementation. Until such data are available, clinicians should consider individualized risk assessment and adopt a multifaceted approach, incorporating both preventative and early detection strategies, to preserve cardiac function and maximize the safety of cancer therapy. CONCLUSION: A multifaceted approach incorporating pharmacologic therapy, exercise, imaging surveillance, and drug formulation strategies can potentially mitigate chemotherapy-induced cardiotoxicity. Large-scale, well-designed randomized trials are needed to optimize timing, patient selection, and combinations of cardioprotective interventions. Until such data are available, individualized risk assessment and early intervention remain key to preserving cardiac function in patients undergoing potentially cardiotoxic chemotherapy. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670914","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}