Prevention, Detection, and Management of Heart Failure in Patients Treated for Breast Cancer.
Agneta Månsson BrobergJürgen GeislerSuvi TuohinenTanja SkyttaÞórdís Jóna HrafnkelsdóttirKirsten Melgaard NielsenElham HedayatiTorbjørn OmlandBirgitte V OffersenAlexander R LyonGeeta GulatiPublished in: Current heart failure reports (2020)
Baseline treatment of cardiovascular risk factors is recommended. Anthracycline and trastuzumab treatment constitute a substantial risk of developing cardiotoxicity. There is growing evidence that this can be treated with beta blockers and angiotensin antagonists. Early detection of cardiotoxicity with cardiac imaging and circulating cardiovascular biomarkers is currently evaluated in clinical trials. Chest wall irradiation accelerates atherosclerotic processes and induces fibrosis. Immune checkpoint inhibitors require consideration for surveillance due to a small risk of severe myocarditis. Cyclin-dependent kinases4/6 inhibitors, cyclophosphamide, taxanes, tyrosine kinase inhibitors, and endocrine therapy have a lower-risk profile for cardiotoxicity. Preventive and management strategies to counteract cancer treatment-related left ventricular dysfunction or heart failure in breast cancer patients should include a comprehensive cardiovascular risk assessment and individual clinical evaluation. This should include both patient and treatment-related factors. Further clinical trials especially on early detection, cardioprevention, and management are urgently needed.
Keyphrases
- heart failure
- left ventricular
- clinical trial
- cardiovascular risk factors
- public health
- cardiovascular disease
- clinical evaluation
- metabolic syndrome
- oxidative stress
- stem cells
- high dose
- mass spectrometry
- replacement therapy
- low dose
- cell cycle
- early onset
- atrial fibrillation
- acute myocardial infarction
- study protocol
- angiotensin ii
- cell proliferation
- acute coronary syndrome
- label free
- drug induced
- phase iii
- tyrosine kinase
- catheter ablation
- cell cycle arrest