Update in imaging of cancer therapy-related cardiac toxicity in adults.
Esmée C de BaatWilleke R NaaktgeborenTim LeinerArco J TeskeJesse HabetsHeynric B GrotenhuisPublished in: Open heart (2021)
Over the past decades, prognosis of patients with cancer has strongly improved and the number of cancer survivors is rapidly growing. Despite this success, cancer treatment is associated with development of serious cardiovascular diseases including left ventricular (LV) systolic dysfunction, heart failure, valvular disease, myocardial infarction, arrhythmias or pericardial diseases. Serial non-invasive cardiac imaging is an important tool to detect early signs of cardiotoxicity, to allow for timely intervention and provide optimal circumstances for long-term prognosis. Currently, echocardiographic imaging is the method of choice for the evaluation of myocardial function during and after cancer therapy. However, 2D echocardiography may fail to detect subtle changes in myocardial function, potentially resulting in a significant delay of therapeutic intervention to impede advanced cardiac disease states with more overt systolic dysfunction. Strain imaging is a promising method for early detection of myocardial dysfunction and may predict future changes in LV ejection fraction. The use of three-dimensional echocardiography may overcome the limitations of 2D echocardiography with more precise and reproducible measurements of LV performance. Cardiac MRI is the gold standard for volumetric assessment and can also be used to perform myocardial tissue characterisation. Visualisation of oedema and fibrosis may provide insights into the degree and disease course of cardiotoxicity and underlying pathophysiological mechanisms. There is growing body of literature regarding the promising role of these advanced imaging modalities in early detection of cardiotoxicity. With this overview paper, new insights and recent results in literature regarding echocardiographic and cardiac magnetic resonance imaging of cancer therapy-related cardiac dysfunction in post-cancer therapy adults will be highlighted.
Keyphrases
- left ventricular
- cancer therapy
- heart failure
- aortic stenosis
- hypertrophic cardiomyopathy
- cardiac resynchronization therapy
- acute myocardial infarction
- high resolution
- left atrial
- mitral valve
- magnetic resonance imaging
- drug delivery
- ejection fraction
- oxidative stress
- randomized controlled trial
- cardiovascular disease
- systematic review
- computed tomography
- acute coronary syndrome
- blood pressure
- metabolic syndrome
- young adults
- coronary artery disease
- magnetic resonance
- cardiovascular events
- pulmonary hypertension
- fluorescence imaging
- decision making
- acute heart failure