scholarly journals Cardiooncology—dealing with modern drug treatment, long-term complications, and cancer survivorship

2021 ◽  
Author(s):  
Claudia de Wall ◽  
Johann Bauersachs ◽  
Dominik Berliner
Keyword(s):  
Side Effects ◽  
Checkpoint Inhibitors ◽  
Heart Diseases ◽  
Tumor Therapy ◽  
Treatment Strategies ◽  
Tumor Treatment ◽  
Cardiac Side Effects ◽  
Cardiovascular Side Effects ◽  
Modern Drug

AbstractModern treatment strategies have improved prognosis and survival of patients with malignant diseases. The key components of tumor treatment are conventional chemotherapy, radiotherapy, targeted therapies, and immunotherapy. Cardiovascular side-effects may occur in the early phase of tumor therapy or even decades later. Therefore, knowledge and awareness of acute and long-lasting cardiac side effects of anti-cancer therapies are essential. Cardiotoxicity impairs quality of life and overall survival. The new cardiologic subspecialty ‘cardio-oncology’ deals with the different cardiovascular problems arising from tumor treatment and the relationship between cancer and heart diseases. Early detection and treatment of cardiotoxicity is of crucial importance. A detailed cardiac assessment of patients prior to administration of cardiotoxic agents, during and after treatment should be performed in all patients. The current review focusses on acute and long-term cardiotoxic side effects of classical cytotoxic and selected modern drug treatments such as immune checkpoint inhibitors and discusses strategies for the diagnosis of treatment-related adverse cardiovascular effects in cancer patients.

Amiodarone neurotoxicity: the other side of the medal

Open Medicine ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. 437-442 ◽  
Author(s):  
Giuliana Galassi ◽  
Eleni Georgoulopoulou ◽  
Alessandra Ariatti
Keyword(s):  
Side Effects ◽  
Brain Magnetic Resonance Imaging ◽  
P100 Latency ◽  
Sensorimotor Polyneuropathy ◽  
Mechanisms Of Toxicity ◽  
Cardiac Side Effects ◽  
Patients At Risk ◽  
Laboratory Examinations ◽  
Magnetic Resonance Imaging Mri

AbstractThe efficacy of amiodarone is tempered by its toxicity, with 50% of long-term users discontinuing the drug. The non-cardiac side effects of amiodarone may involve central and peripheral nervous system. We studied two patients treated with amiodarone for 46 and 15 months respectively. Both patients exhibited progressive distal extremity weakness, impaired perception, loss of deep reflexes. Electrophysiology identified a widespread, sensorimotor polyneuropathy with features of axonal loss and demyelination. Visual evoked potentials (VEPs) showed prolonged P100 latency bilaterally in absence of visual symptoms or brain magnetic resonance imaging (MRI) abnormalities. Extensive laboratory examinations excluded known causes of peripheral neuropathies. At 21 months after amiodarone withdrawal, P100 latency of case 1 VEPs returned to normal, whereas polyneuropathy continued to progress. In the second patient neuropathy has worsened similarly over 2 years whereas P100 latency of VEPs recovered to normal within 7 months after withdrawal of amiodarone. These findings may suggest different mechanisms of toxicity, which could be due to amiodarone pharmacokinetic and its metabolite effects on the peripheral nerves, as opposed to the optic nerve. We emphasize that use of amiodarone needs monitoring of patients at risk of development side effects.

scholarly journals Chemotherapy-Induced Cardiotoxicity: Pathophysiology and Prevention

2014 ◽  
Vol 87 (3) ◽  
pp. 135-142 ◽  
Author(s):  
Melinda Csapo ◽  
Liviu Lazar
Keyword(s):  
Side Effects ◽  
Adverse Reactions ◽  
Cardiac Toxicity ◽  
Negative Impact ◽  
Therapeutic Strategies ◽  
Oncological Treatment ◽  
Cardiac Side Effects ◽  
Long Term Survivors ◽  
Remarkable Progress

Along with the remarkable progress registered in oncological treatment  that led to increased survival of cancer patients, treatment-related comorbidities have also become an issue for these long-term survivors. Of particular interest is the development of cardiotoxic events, which, even when asymptomatic, not only have a negative impact on the patient`s cardiac prognosis, but also considerably restrict therapeutic opportunities. The pathophysiology of cytostatic-induced cardiotoxicity implies a series of complex and intricate mechanisms, whose understanding enables the development of preventive and therapeutic strategies. Securing cardiac function is an ongoing challenge for the pharmaceutical industry and the physicians who have to deal currently with these adverse reactions. This review focuses on the main mechanism of cardiac toxicity induced by anticancer drugs and especially on the current strategies applied for preventing and minimizing the cardiac side effects.

scholarly journals Getting to the Heart of the Matter: An Overview of Cardiac Toxicity Related to Cancer Therapy

2015 ◽  
Vol 9s2 ◽  
pp. CMC.S19704 ◽  
Author(s):  
Carine E. Hamo ◽  
Michelle Weisfelner Bloom
Keyword(s):  
Radiation Therapy ◽  
Side Effects ◽  
Cancer Therapy ◽  
Patient Outcomes ◽  
Cancer Survival ◽  
Cardiac Toxicity ◽  
Early Recognition ◽  
Cancer Therapies ◽  
Cardiovascular Side Effects

With the improvement in cancer survival, long-term cardiotoxicity has become an area of increased interest. Various cancer therapies, including chemotherapy and radiation therapy can lead to cardiac toxicities with both acute and chronic manifestations. Awareness and early recognition can lead to improvement in cardiac survival and patient outcomes. The focus of this review is to summarize the cancer therapy agents most often associated with cardiovascular side effects, highlighting their mechanism of action and strategies for surveillance and prevention.

scholarly journals Electrocardiographic changes of antidepressant medication in depressive episode

2018 ◽  
Vol 5 (3) ◽  
pp. 505
Author(s):  
Dheerendra Kumar Mishra ◽  
Pradeep Kumar
Keyword(s):  
Side Effects ◽  
Depressive Episode ◽  
Antidepressant Medication ◽  
Post Treatment ◽  
Controlled Study ◽  
High Dose ◽  
Close Monitoring ◽  
Cardiac Side Effects ◽  
Cardiovascular Side Effects ◽  
Electrocardiographic Changes

Introduction: Depressive disorder is leading cause of mortality in the world, with the help of recent therapeutic strategies it is easily manageable. Antidepressant medication is the most commonly used for management of depressive disorders. Among the side effects of antidepressant, cardiovascular effects of antidepressant deserve close monitoring. Invariably, it is observed that patients undergoing antidepressant therapy are not screened for pre-existing cardiovascular diseases and more so for cardiotoxicity. Various antidepressant medications are available, with different cardiac side effects profile. Ignorance, over clinical burden, poor follow up and under evaluation of cardiovascular side effects could be attributable to an ultimate surveillance of such cases. So, this study conducted to evaluate electrocardiographic changes in therapeutic doses of antidepressant medication.Methods: An Open label-controlled study was conducted on 386 subjects to evaluate the antidepressant-induced electrocardiographic changes. Treatment seeking subjects for the depressive episode was recruited from outpatient and inpatient section of Psychiatry department after fulfilling inclusion and exclusion criteria. Data was collected on socio-demographic characteristics, and detailed pre-treatment and post-treatment clinical evaluation and electrocardiographic assessment were done.Results: Data collected and analyzed from 204 subjects, mean age of subjects taking tricyclics and SSRI (Fluoxitine) 43.6±7.5 years vs 41.5±9.6 years respectively. The study sample consists of 66% females, 33% males. Among them, 35% study subject expose to tricyclics and 65% subjects taking SSRI. 19% study subjects presented electrocardiograph changes especially tachycardia among them 55% was taking the tricyclic antidepressant. Only 10% subjects taking SSRI had post-treatment abnormal electrocardiograph changes.Conclusions: Conclusively, antidepressant form a safe therapeutic modality for the management of major depression. Its cardiovascular side effects warrant against indiscriminate use of particularly in high dose and old aged person and preexisting cardiac disease.

CANCER TREATMENT AND CARDIOVASCULAR TOXITY: PATHOGENESIS AND ACTUAL APPROACHES TO THE DIAGNOSIS OF HEART FAILURE IN CANCER PATIENTS

2019 ◽  
Vol 65 (2) ◽  
pp. 172-180
Author(s):  
Andrey Obrezan ◽  
Nataliya Shcherbakova
Keyword(s):  
Cardiovascular Diseases ◽  
Side Effects ◽  
Cancer Treatment ◽  
Baseline Risk ◽  
Patients With Cancer ◽  
Treatment Side Effects ◽  
Cardiovascular Side Effects ◽  
Life Saving

The field of cardio-oncology has received increasing attention in recent years. This is due to the fact that the results of a large number of clinical studies on antitumor therapy, covering issues treatments side effects, including associated cardiovascular pathology, are published. Advances in treatment have led to improved survival of patients with cancer, but have also increased clinical significance of treatment side effects. Myocardium, having high metabolic activity, responds to substrate and energy imbalance under the action of increasing malignancy and toxic effects of radio- or chemotherapy. Finding of baseline risk factors, timely identification of cardiovascular diseases, ability to predict the long-term consequences of cancer treatment-associated cardiovascular side effects lead to improving of the prognosis and quality of life, avoiding of over-diagnosis cardiovascular diseases and inappropriating violation of life-saving treatment of a malignant tumor.

Letter To The Editor

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 799-800
Author(s):  
Manuel Durand ◽  
Smeeta Sardesai ◽  
Cindy McEvoy
Keyword(s):  
Birth Weight ◽  
Side Effects ◽  
Low Birth Weight ◽  
Steroid Therapy ◽  
Chronic Lung Disease ◽  
Very Low Birth Weight ◽  
Vlbw Infants ◽  
Cardiac Side Effects ◽  
Dexamethasone Therapy

We thank Dr Zecca and associates for their interest in our paper.1 Their concerns regarding possible cardiac side effects during steroid therapy in very low birth weight (VLBW) infants are quite appropriate and, we feel, further emphasize the benefits of an "early" (mean postnatal age, 9 to 10 days) and "short" (7 days) course of dexamethasone therapy for this group of infants at risk for long-term pulmonary morbidities. The prior studies they have referenced2-5 and another recent study6 applied longer courses of steroid therapy (up to 42 days) to infants with well-established chronic lung disease (CLD).

Long-term immune-related adverse events after discontinuation of immunotherapy

Immunotherapy ◽  
2021 ◽  
Author(s):  
Karoline Horisberger ◽  
Carmen Portenkirchner ◽  
Andreas Rickenbacher ◽  
Luc Biedermann ◽  
Christoph Gubler ◽  
...  
Keyword(s):  
Side Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Late Onset ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Symptomatic Therapy ◽  
Checkpoint Inhibitor Therapy ◽  
Severe Colitis

Immune checkpoint inhibitors have revolutionized the treatment of various cancers but are notorious for their potential to cause severe side effects. While most side effects occur during ongoing therapy, an increasing number of reports of late onset have emerged. It is also not yet clear how long side effects can last. Resolution is achieved under symptomatic therapy, but the side effects may persist latently. We present a patient case with recurrence of colitis after closure of an ileostomy over 1 year after discontinuation of immune checkpoint inhibitor therapy with nivolumab and pembrolizumab. To the best of our knowledge, no other case with severe colitis still lasting after more than a year of suspension of therapy has yet been reported.

Cardiovascular risk in men with prostate cancer

ESC CardioMed ◽  
2018 ◽  
pp. 1178-1181
Author(s):  
Daniel Perry ◽  
Megan Caram ◽  
Monika Leja
Keyword(s):  
Prostate Cancer ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Side Effects ◽  
Systemic Therapy ◽  
Treatment Strategies ◽  
Current Evidence ◽  
Cardiovascular Risks ◽  
Prostate Cancer Treatment ◽  
Cardiovascular Side Effects

Among patients with prostate cancer, non-cancer-related deaths outnumber cancer-related deaths. Given that the majority of men with prostate cancer are over the age of 70 years, cardiovascular disease is one of the primary co-morbidities to consider when deciding on treatment strategies. This chapter discusses the current evidence on the cardiovascular risks of common treatments for prostate cancer, with emphasis on androgen deprivation therapy, chemotherapy, and newer secondary hormonal agents. Additionally it provides recommendations for monitoring patients for cardiovascular side effects when the decision is made to start systemic therapy. It is important to note that there are a limited number of randomized trials studying this field, and further research is needed given the continuous advancements being made in prostate cancer treatment.

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