Cardio-oncology最新文献

{"title":"CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 - metastatic breast cancer.","authors":"Susan Dent, Avirup Guha, Heather Moore, Doris Makari, Rachael McCaleb, Irene Arias, Stella Stergiopoulos, Benjamin Li, Michael Fradley","doi":"10.1186/s40959-025-00305-w","DOIUrl":"10.1186/s40959-025-00305-w","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular (CV) comorbidities and concurrent medications with risk of heart rate-corrected QT interval (QTc) prolongation can impact treatment decisions and safety discussions for patients with breast cancer. However, limited data are available regarding their prevalence in patients with HR + /HER2- metastatic breast cancer (mBC). We evaluated the prevalence of CV comorbidities, the use of concurrent medications with risk of QTc prolongation, and treatment patterns in patients with newly diagnosed HR + /HER2 - mBC.</p><p><strong>Methods: </strong>This retrospective analysis utilized claims data from Merative™ Marketscan® Commercial and Medicare databases. Claims-based algorithms identified patients with newly diagnosed HR + /HER2- mBC between January 2016 and December 2022. The index date was defined as the first date of an mBC claim during this period. For each patient, data on pre-existing CV comorbidities and first-line treatments were captured for 12 months before and 6 months after the index date, respectively.</p><p><strong>Results: </strong>A total of 6525 patients with newly diagnosed HR + /HER2 - mBC were identified. At mBC diagnosis, 61.7% of patients had ≥ 1 CV comorbidity. Of patients with CV comorbidities, 22.5% and 30.6% took 1 or ≥ 2 medications, respectively, with risk of QTc prolongation. First-line use of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors increased from 22.1% of patients with CV comorbidities diagnosed in 2016-2017 to 31.5% of those diagnosed in 2018-2022.</p><p><strong>Conclusions: </strong>We found that CV comorbidities and use of medications with risk of QTc prolongation were common in patients with newly diagnosed HR + /HER2 - mBC. These factors should inform treatment decision-making (including CDK4/6 inhibitor selection), safety discussions with patients, and CV monitoring.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"7"},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051755","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":"Retraction Note: Navigating the crossroads: cardiometabolic risks in cancer survivorship - a comprehensive review.","authors":"Arif Albulushi, Aisha Al Balushi, Muhhamed Shahzad, Ismail Al Bulushi, Hatim Al Lawati","doi":"10.1186/s40959-025-00306-9","DOIUrl":"10.1186/s40959-025-00306-9","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"6"},"PeriodicalIF":3.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028055","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":"Cardiovascular health in breast cancer patients: insight on BRCA1/2 mutations impact.","authors":"Panagiotis Mallios, Mehdi Dehghan Manshadi, Laila Hubbert, Tajeri Aydin, Claudia Maes, Johanna Rantala, Annelie Liljegren, Narsis A Kiani, Elham Hedayati","doi":"10.1186/s40959-025-00302-z","DOIUrl":"10.1186/s40959-025-00302-z","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) and cardiovascular disease (CVD) are prevalent comorbidities in aging populations. Advances in BC treatment have improved survival rates but increased the risk of CVD, particularly among younger patients with BRCA1/2 mutations. BRCA1/2 gene mutations, prevalent in younger BC patients, impair cardioprotective effects, elevating CVD risk alongside cancer treatments. This study examined the prevalence and incidence of CVD and cardiovascular risk factors (CVRFs) before and after BC diagnosis in BRCA1/2 mutation carriers (BRCA-BC) and those with sporadic BC (Sporadic-BC).</p><p><strong>Methods: </strong>This descriptive retrospective cohort study analyzed BC patients from 1995 to 2020 in Stockholm-Gotland, Sweden. Data from regional and national registries provided insights into CVRFs, pre-existing CVDs, demographics, and cancer treatments. Analyses focused on single and multiple CVD events, comparing inpatient and outpatient settings across subgroups.</p><p><strong>Results: </strong>The cohort included 438 BRCA-BC and 32,626 Sporadic-BC patients. BRCA-BC patients were younger at BC diagnosis (median: 45 years, IQR 37-53) and first CVD event (median: 62 years, IQR 53-68) compared to Sporadic-BC patients (median: 61 years, IQR 51-71; and 74 years, IQR 65-81, respectively). Before BC diagnosis, CVD prevalence was lower in BRCA-BC patients (4.2%) than in Sporadic-BC patients (11.1%). Post-diagnosis, CVD prevalence increased in both groups, reaching 19.7% in BRCA-BC and 24.6% in Sporadic-BC patients. Heart failure (HF) was the most common major adverse cardiovascular event (MACE), affecting 4.6% of BRCA-BC and 9.5% of Sporadic-BC patients. Sporadic-BC patients exhibited a higher overall cardiovascular burden, including arrhythmias, coronary artery disease, and stroke.</p><p><strong>Conclusions: </strong>Distinct cardiovascular profiles between BRCA-BC and Sporadic-BC patients underscore the need for tailored survivorship care. Early cardiovascular screening benefits BRCA-BC patients, while Sporadic-BC patients require comprehensive management of pre-existing CVRFs. These findings align with international cardio-oncology guidelines advocating integrated cardiovascular care for BC survivors.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"5"},"PeriodicalIF":3.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000796","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":"Nursing knowledge in cardio-oncology: results of an international learning needs-assessment survey.","authors":"Anecita Fadol, Geraldine Lee, Valerie Shelton, Kelly C Schadler, Asma Mohammed Younus, Mary Stuart, Lisa Nodzon, Edith Pituskin","doi":"10.1186/s40959-025-00304-x","DOIUrl":"10.1186/s40959-025-00304-x","url":null,"abstract":"<p><strong>Background: </strong>With early detection and improvements in systemic and local therapies, millions of people are surviving cancer, but for some at a high cost. In some cancer types, cardiovascular disease now competes with recurrent cancer as the cause of death. Traditional care models, in which the cardiologist or oncologist assess patients individually, do not address complex cancer and cardiovascular needs. Nursing disciplines should be an integral part of holistic assessment in cardio-oncology care. To learn what educational needs nurses perceive important for provision of competent cardio-oncology nursing care, we undertook an international survey, aiming to understand their learning needs and preferred learning modalities.</p><p><strong>Methods: </strong>A cross-sectional survey was developed by members of the International Cardio-Oncology Society (IC-OS) Nursing Research group. The survey was in English and consisted of 23 questions which include demographic information, clinical specialty (oncology, cardiology, or cardio-oncology), multiple-choice questions related to clinical topics that nurses might be interested in learning, and preferred methods of instruction.</p><p><strong>Results: </strong>Three hundred and twenty-nine responses were received. The majority expressed interest in learning more about cardio-oncology related topics, primarily via pre-recorded webinars (n = 206, 67%) and live virtual meetings (n = 192, 63%). Formal programs leading to certification were highly endorsed (n = 247, 80%). In relation to specific cardio-oncology topics, there was a strong interest in learning more about specific cardiovascular toxicities, and their monitoring and management (n = 205, 66%).</p><p><strong>Conclusion: </strong>Cardio-oncology is a new field of expertise requiring competent nurses with current knowledge incorporating both specialties. The survey we conducted described the sample's characteristics, identified cardio-oncology learning needs and preferred methods of delivery. A cardio-oncology core curriculum based on the survey responses can offer convenient, accessible and learner-directed education for nurses worldwide. Ultimately, development of cardio-oncology nursing expertise will benefit cancer patients and survivors worldwide.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"4"},"PeriodicalIF":3.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000802","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":"Cardiovascular safety of 5-fluorouracil and capecitabine in colorectal cancer patients: real-world evidence.","authors":"Chun-Ka Wong, Isaac Ho, Ali Choo, Rachel Lau, Ting-Fung Ma, Alston Conrad Ho-On Chiu, Tsun-Ho Lam, Minqing Lin, Ricky Wang-Hei Leung, Frankie Chor-Cheung Tam, Dominic Chi Chung Foo, Hung-Fat Tse","doi":"10.1186/s40959-024-00294-2","DOIUrl":"10.1186/s40959-024-00294-2","url":null,"abstract":"<p><strong>Background: </strong>Fluoropyrimidines, including 5-fluorouracil and capecitabine, are the most common chemotherapeutic agents for colorectal carcinoma. Although previous studies have suggested varying degrees of cardiotoxicity with these drugs, there is a notable lack of large-scale investigations with appropriate control groups. This study aimed to evaluate cardiovascular outcome among colorectal carcinoma patients treated with fluoropyrimidines.</p><p><strong>Methods: </strong>A retrospective propensity score- matched cohort study was conducted in patients diagnosed with colorectal carcinoma between January 1, 1993 and December 31, 2021 at public hospitals in Hong Kong. Cardiovascular outcomes in patients prescribed fluoropyrimidines were compared with controls. Further analyses to compare 5-fluroracil and capecitabine were performed.</p><p><strong>Results: </strong>A total of 51,888 colorectal carcinoma patients were identified. After 1:1 propensity score matching, 21,216 patients were included in the final analysis, with 10,608 patients in each group. 1.06% patients experienced a major adverse cardiovascular event (MACE) at 1 year. There was no significant difference in MACE risk between the two groups (HR 0.91, 95% confidence interval (95%CI): 0.70-1.18, p = 0.46). Risk of cardiovascular death was similar between the two groups (HR 1.05, 95%CI: 0.69-1.60, p = 0.82). Subgroup analysis did not demonstrate a statistically significant elevated risk of MACE during fluoropyrimidine use in high-risk patient groups. Further comparison of 5-fluorouracil and capecitabine did not reveal a difference in MACE (0.80% vs. 0.98%; HR 1.09, 95%CI: 0.64-1.85, p < 0.75).</p><p><strong>Conclusion: </strong>Fluoropyrimidine use in patients with colorectal carcinoma did not increase the risk of MACE, cardiovascular death, or other specific cardiovascular conditions. There was no significant difference in cardiovascular risk between 5-fluorouracil and capecitabine.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"3"},"PeriodicalIF":3.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000799","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":"Safety and efficacy of immune checkpoint inhibitors in patients with pre-treatment reduced left ventricular function.","authors":"Maor Tzuberi, Rafael Y Brzezinski, Nir Flint, Moaad Slieman, Lior Zornitzki, Dana Viskin, Anna Rozenfeld Hemed, Barliz Waissengrin, Renana Barak, Inbal Golomb, Ido Wolf, Netanel Golan, Yan Topilsky, Shmuel Banai, Livia Kapusta, Michal Laufer-Perl","doi":"10.1186/s40959-024-00297-z","DOIUrl":"10.1186/s40959-024-00297-z","url":null,"abstract":"<p><strong>Aims: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment outcomes. However, the response varies across different populations, and their use may lead to life-threatening cardiovascular (CV) events. While pre-treatment reduced left ventricular ejection fraction (LVEF) is considered a marker for high-risk cardiotoxicity and a contraindication for anthracycline and HER2-targeted therapies, there is limited evidence on the safety and efficacy of ICIs therapy in patients presenting with pre-treatment reduced LVEF. The study aims to evaluate the safety and efficacy of ICIs therapy in patients with pre-treatment reduced LVEF.</p><p><strong>Methods: </strong>Retrospective single center cohort of patients treated with ICIs therapy, who performed pre-treatment LVEF assessment. The primary endpoint was to evaluate the safety of ICIs among this population, assessed by CV events (composite of myocarditis, acute coronary syndrome, heart failure, and arrhythmias). The secondary endpoint was to evaluate the efficacy of ICIs, assessed by all-cause mortality and progression-free survival (PFS).</p><p><strong>Results: </strong>The cohort included 307 patients, with 30 (10%) presenting with pre-treatment reduced LVEF, with a mean LVEF of 39 ± 7%. While a significantly higher incidence of CV events was observed in the reduced LVEF group (37% vs. 14%, p = 0.004), following a multivariate Cox regression analysis including baseline CV diseases and risk factors, pre-treatment reduced LVEF did not remain a significant independent predictor (p = 0.358). No significant differences were observed between the groups regarding all-cause mortality and PFS.</p><p><strong>Conclusions: </strong>Pre-treatment reduced LVEF was not identified as an independent marker for clinical outcomes in patients treated with ICIs therapy.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"2"},"PeriodicalIF":3.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945558","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":"Cardiorespiratory fitness, cardiac morphology and function, and cardiovascular risk factors in long-term breast cancer survivors compared with non-cancer controls.","authors":"Mali Sæter, Sara Hassing Johansen, Kristin Valborg Reinertsen, Lene Thorsen, Kristina Hermann Haugaa, Tormod Skogstad Nilsen, Sebastian Imre Sarvari","doi":"10.1186/s40959-024-00296-0","DOIUrl":"https://doi.org/10.1186/s40959-024-00296-0","url":null,"abstract":"<p><strong>Background: </strong>Although anthracycline-related cardiotoxicity is widely studied, only a limited number of echocardiographic studies have assessed cardiac function in breast cancer survivors (BCSs) beyond ten years from anthracycline treatment, and the knowledge of long-term cardiorespiratory fitness (CRF) in this population is scarce. This study aimed to compare CRF assessed as peak oxygen uptake (V̇O₂), cardiac morphology and function, and cardiovascular (CV) risk factors between long-term BCSs treated with anthracyclines and controls with no history of cancer.</p><p><strong>Methods: </strong>The CAUSE (Cardiovascular Survivors Exercise) trial included 140 BCSs recruited through the Cancer Registry of Norway, who were diagnosed with breast cancer stage II to III between 2008 and 2012 and had received treatment with epirubicin, and 69 similarly aged activity level-matched controls. All the participants underwent blood sampling, blood pressure measurements, echocardiography and cardiopulmonary exercise testing from October 2020 to August 2022.</p><p><strong>Results: </strong>BCSs were aged 59 ± 6 years and had received a cumulative dose of 357 (243 to 366) mg/m² of epirubicin on average 11 ± 1 years before inclusion. There was no difference between BCSs and controls with respect to peak V̇O₂ (27.6 ± 5.4 mL/kg/min vs. 27.1 ± 5.4 mL/kg/min, P = 0.25), 2D left ventricular ejection fraction (57 ± 3% vs. 57 ± 3%, P = 0.43), left ventricular global longitudinal strain (-20.5 ± 1.0% vs. -20.6 ± 1.0%, P = 0.46) or the proportion with N-terminal pro-brain natriuretic peptide ≥ 125 (22% vs. 20%, P = 0.93). The proportions with hypertension, dyslipidemia or diabetes did not differ between the groups.</p><p><strong>Conclusion: </strong>We found that CRF, cardiac function, and CV risk profile in BCSs examined a decade after treatment with anthracyclines were similar to that in women with no history of cancer.</p><p><strong>Trial registration: </strong>clinicaltrials.gov (NCT04307407) https://clinicaltrials.gov/ct2/show/NCT04307407 .</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926829","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":"Assessment of cardio-oncology knowledge and practice among healthcare providers in Saudi Arabia: a comprehensive nationwide survey.","authors":"Hisham A Badreldin, Nada Alsuhebany, Lama Alfehaid, Mohammed Alzahrani, Maha Aldoughaim, Abdullah M Alrajhi, Jumanah Alsufyani, Dania Elsherif, Kanan Alshammari","doi":"10.1186/s40959-024-00299-x","DOIUrl":"10.1186/s40959-024-00299-x","url":null,"abstract":"<p><strong>Introduction: </strong>The evolving field of oncology necessitates effective management of cancer-related cardiovascular diseases. In Saudi Arabia, the incidence of cancer is rising, and there is a critical need for cardio-oncology services to address cancer treatment-related cardiovascular toxicity. This study aimed to evaluate the knowledge and practices of healthcare providers (HCPs) in Saudi Arabia regarding cardio-oncology.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from January 2024 to April 2024 using an online survey targeting cardiologists, oncologists, and clinical pharmacists. The survey assessed demographics, perceptions of cardio-oncology, availability of services, and current practices. Data were analyzed using descriptive statistics, chi-squared tests, and bivariate analyses.</p><p><strong>Results: </strong>The survey received responses from 116 HCPs, including cardiologists (63.79%), oncologists (23.28%), and clinical pharmacists (12.93%). Most participants had over six years of experience, and only one had formal cardio-oncology training. While 84.48% recognized the importance of managing cardiac complications in cancer patients, only 42.24% were familiar with existing guidelines. Limited training programs and institutional resources were significant barriers to implementing cardio-oncology services. Despite agreement on the need for cardiotoxicity management, only one-third recommended cardioprotective agents as standard care.</p><p><strong>Conclusion: </strong>There is a notable deficiency in formal training and resources for cardio-oncology in Saudi Arabia. To bridge this gap, integrating cardio-oncology into training programs, establishing institutional guidelines, and adopting multidisciplinary care models are crucial. These measures will enhance the quality of care for cancer patients and improve their cardiovascular outcomes.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"10 1","pages":"93"},"PeriodicalIF":3.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906346","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":"Epidemiology, risk factors and mechanism of breast cancer and atrial fibrillation.","authors":"Xiaoxue Guo, Zheng Zuo, Xishu Wang, Ying Sun, Dongyang Xu, Guanghui Liu, Yi Tong, Zhiguo Zhang","doi":"10.1186/s40959-024-00298-y","DOIUrl":"10.1186/s40959-024-00298-y","url":null,"abstract":"<p><p>Cancer and cardiovascular diseases are leading causes of death worldwide. Among them, breast cancer is one of the most common malignancies in women, while atrial fibrillation is one of the most extensively studied arrhythmias, with significant public health implications. As the global population ages and advancements in cancer treatments continue, the survival rates of breast cancer patients have significantly improved, leading to an increasing coexistence of breast cancer and atrial fibrillation. However, the mechanisms underlying this coexistence remain insufficiently studied, and there is no consensus on the optimal treatment strategies for these patients. This review consolidates existing research to systematically explore the epidemiological characteristics, risk factors, and pathophysiological mechanisms of both breast cancer and atrial fibrillation. It focuses on the unique signaling pathways associated with different molecular subtypes of breast cancer and their potential impact on the mechanisms of atrial fibrillation. Additionally, the relationship between atrial fibrillation treatment medications and breast cancer is discussed. These insights not only provide essential evidence for the precise prevention and management of atrial fibrillation in breast cancer patients but also lay a solid theoretical foundation for interdisciplinary clinical management practices.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"10 1","pages":"92"},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881388","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":"Baseline echocardiographic variables as predictors of hemodynamically significant cytokine release syndrome in adults treated with CD19 CAR T-cell therapy for hematological malignancies.","authors":"Andres E Daryanani, Muhannad A Abbasi, Maria F Gomez Ardila, Eduardo Tellez-Garcia, Juan M Garzon-Dangond, Yi Lin, Jonas Paludo, Joerg Herrmann, Stephen M Ansell, Allison C Rosenthal, Hector R Villarraga","doi":"10.1186/s40959-024-00290-6","DOIUrl":"10.1186/s40959-024-00290-6","url":null,"abstract":"<p><strong>Background: </strong>CD19 CAR T-cell therapy is a novel anti-cancer treatment that has produced remarkable responses in relapsed or refractory B-cell hematological malignancies. Cytokine Release Syndrome (CRS) is a dysregulated immune response that frequently occurs after CAR T-cell infusion. It can cause cardiac dysfunction and circulatory collapse negatively impacting outcomes and survival. To endure the insults of CRS, patients are typically screened for adequate cardiac reserve before treatment. The relationship between baseline cardiac function by echocardiography and the development of moderate to severe presentations of CRS is unclear.</p><p><strong>Methods: </strong>This study aimed to identify baseline echocardiographic variables that can predict the development of hemodynamically significant CRS (CRS ≥ 2), evaluate their behavior at follow-up, and investigate the incidence of cancer therapy-related cardiac dysfunction (CTRCD). An observational retrospective cohort study of patients treated with CD19 CAR T-cell therapy with a baseline echocardiogram was performed. Demographic, clinical and echocardiographic variables were abstracted from the electronic health record. Patients were grouped and compared by the occurrence of CRS < 2 and ≥ 2. Adjusted logistic regression analysis was used to evaluate the association between echocardiographic variables and the development of CRS ≥ 2.</p><p><strong>Results: </strong>291 patients were included in the study. Median age was 60 (IQR: 51, 67 years), 73% were male, and 71% had diffuse large B-cell lymphoma. Logistic regression analysis did not reveal any significant baseline echocardiographic predictors of CRS ≥ 2, including left ventricular ejection fraction and global longitudinal strain. Systolic and diastolic echocardiographic variables remained within normal limits at follow-up overall and in both CRS groups. The incidence of CTRCD was 4.5% and occurred mostly in the setting of CRS ≥ 2.</p><p><strong>Conclusion: </strong>No specific echocardiographic variables predicted the development of CRS ≥ 2, and therefore the mechanism leading to hemodynamic decompensation and producing worsening hypoxia and hypotension could be multifactorial and not directly cardiac mediated.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"10 1","pages":"91"},"PeriodicalIF":3.2,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871529","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}