Surveillance for cardiotoxicity in patients receiving potentially cardiotoxic chemotherapy

2018 ◽  
Author(s):  
Cian P. McCarthy ◽  
Michael T. Osborne ◽  
Tomas G. Neilan
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Myocardial Injury ◽  
Cancer Survival ◽  
Clinical Presentation ◽  
Imaging Techniques ◽  
Latency Period ◽  
Clinical Imaging ◽  
Detection And Quantification

As cancer survival has improved, some of the focus of care has shifted to minimizing the long-term complications of cancer therapy. Cardiovascular disease is a leading long-term cause of morbidity and mortality in patients who survive cancer. This chapter focuses on current clinical imaging and non-imaging techniques that are used to detect the cardiovascular consequences of chemotherapy. Overall, the detection and quantification of chemotherapy-induced myocardial injury, dysfunction, and heart failure is challenging due to intrinsic limitations of the available imaging techniques coupled with the latency period that can occur between injury and clinical presentation with heart failure.

Surveillance for cardiotoxicity in patients receiving potentially cardiotoxic chemotherapy

ESC CardioMed ◽  
2018 ◽  
pp. 1156-1160
Author(s):  
Magid Awadalla ◽  
Cian P. McCarthy ◽  
Michael T. Osborne ◽  
Tomas G. Neilan
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Cancer Therapy ◽  
Cancer Survival ◽  
Clinical Presentation ◽  
Imaging Techniques ◽  
Latency Period ◽  
Clinical Imaging ◽  
Detection And Quantification

As cancer survival has improved, some of the focus of care has shifted to minimizing the long-term complications of cancer therapy. Cardiovascular disease is a leading long-term cause of morbidity and mortality in patients who survive cancer. This chapter focuses on current clinical imaging and non-imaging techniques that are used to detect the cardiovascular consequences of chemotherapy. Overall, the detection and quantification of chemotherapy-induced myocardial injury, dysfunction, and heart failure is challenging due to intrinsic limitations of the available imaging techniques coupled with the latency period that can occur between injury and clinical presentation with heart failure.

scholarly journals Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

Abstract 16185: Biomarker-based Heart Failure Risk Stratification in Patients With Atherosclerotic Cardiovascular Disease: Observations From HPS-3/TIMI-55-REVEAL

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
David Berg ◽  
Stephen D Wiviott ◽  
Eugene Braunwald ◽  
David A Morrow ◽  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Myocardial Injury ◽  
Cox Regression ◽  
Troponin T ◽  
Risk Indicators ◽  
Atherosclerotic Cardiovascular Disease ◽  
Circulating Biomarkers ◽  
Clinical Risk ◽  
Hemodynamic Stress

Background: Circulating biomarkers reflecting pathways implicated in heart failure (HF) may improve HF risk assessment in patients with stable atherosclerotic cardiovascular disease (ASCVD). Hypothesis: We aimed to evaluate the performance of circulating biomarkers of hemodynamic stress, myocardial injury, and inflammation for the prediction of hospitalization for HF (HHF) in a large well-characterized cohort with stable ASCVD followed for a median of 4.1 years. Methods: HPS3/TIMI 55-REVEAL was a randomized, double-blind, placebo-controlled trial of the CETP inhibitor anacetrapib in patients with stable ASCVD. We performed a nested prospective biomarker study, measuring high-sensitivity troponin T (hsTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and growth differentiation factor-15 (GDF-15) (all Roche Diagnostics) at randomization (n=29,673). Hazard ratios were adjusted for covariates of a priori clinical relevance to HHF risk: age, prior HF, hypertension, diabetes mellitus, eGFR <60, body-mass index, and polyvascular disease. Discrimination was assessed using Harrell’s c-index. Results: A significant graded risk of HHF was observed with increasing deciles of hsTnT, NT-proBNP, and GDF-15 (p-trend <0.001 for each) ( Figure ). These associations remained significant after multivariable adjustment for clinical risk factors (p<0.001 for each). When added to a multivariable Cox regression model of clinical risk indicators (c-index 0.74), these 3 biomarkers significantly improved the prognostic performance of the model (c-index 0.85; p<0.001). There was no treatment interaction with anacetrapib. Conclusions: In patients with stable ASCVD, biomarkers of myocardial injury, hemodynamic stress, and inflammation provide incremental information for prediction of HHF. Future studies should address whether these patients are more likely to benefit from emerging HF preventive therapies.

scholarly journals MENTAL ILL-HEALTH AND HEART FAILURE COMORBIDITY

2019 ◽  
pp. 11-17
Author(s):  
MARIAM AHMED ◽  
HANA MORRISSEY ◽  
PATRICK ANTHONY BALL
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Health Outcomes ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Disease Modification ◽  
Patient Health ◽  
The Cost ◽  
Adherence To Therapy

This review aims to understand the co-existence of mental ill-health and heart failure and if this comorbidity affects patient self-care motivation and overall health outcomes. Databases searched were; PubMed®, Google® scholar and Science Direct® for studies related to heart failure, heart failure and mental health, depression and anxiety. Eleven articles were identified and reviewed. There were two studies disagreed with the theory that the mental ill-health and heart failure has disease modification and worsen patient health outcomes, three studies concluded that only anxiety has effect, five studies concluded that both anxiety and depression have effect, six studies concluded that depression only has effect but all eleven stated that more research is required. Recent theories on depression and cardiovascular disease comorbidity and the effect mental ill-health have on medication adherence in heart failure patients was discussed. People with long-term physical illnesses may suffer further complications to their health if they develop mental illness; increasing the cost of their care by an average of 45%, however, in the majority of these cases, the mental issues neither diagnosed nor treated. This review explored the link between cardiovascular disease (CVD) and mental ill health; and how comorbidity of the two conditions affects patients’ adherence to therapy behaviour. It was concluded that while the link between mental ill health and heart failure (HF) is recognized, studies that may be used as a basis of evidence to confirm this link are scarce.

scholarly journals COVID-19-Related Cardiovascular Disease and Practical Considerations for Perioperative Clinicians

2020 ◽  
Vol 24 (4) ◽  
pp. 293-303 ◽  
Author(s):  
Neal S. Gerstein ◽  
Ranjani Venkataramani ◽  
Andrew M. Goumas ◽  
Niels N. Chapman ◽  
Lev Deriy
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Cardiac Injury ◽  
Case Series ◽  
Multiple Case ◽  
Cv Disease

Coronavirus disease 2019 (COVID-19) has a clinical course predominated by acute respiratory failure due to viral pneumonia with possible acute respiratory distress syndrome. However, nearly one third of infected patients, especially those with preexisting cardiovascular (CV) disease, are reported to present with some combination of acute cardiac injury, myocarditis, heart failure, cardiogenic shock, or significant dysrhythmias. In addition, COVID-19 infections are also associated with high rates of thromboembolic and disseminated intravascular coagulation complications. Severe myocarditis and heart failure have both been reported as the initial presenting conditions in COVID-19 infection. This review highlights the important considerations related to the CV manifestations of COVID-19 infections, describes the mechanisms and clinical presentation of CV injury, and provides practical management and therapy suggestions. This narrative review is based primarily on the multiple case series and cohorts from the largest initial COVID-19 outbreak centers (ie, Wuhan, China, and Italy); hence, nearly all presented data and findings are retrospective in nature with the attendant limitations of such reports.

scholarly journals An Incidentally Detected Right Ventricular Pseudoaneurysm

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Vamsi C. Gaddipati ◽  
Angel I. Martin ◽  
Mauricio O. Valenzuela ◽  
Asef Mahmud ◽  
Aarti A. Patel
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Right Ventricular ◽  
Chest Trauma ◽  
Clinical Presentation ◽  
Acute Decompensated Heart Failure ◽  
Imaging Techniques ◽  
Decompensated Heart Failure ◽  
Advanced Imaging ◽  
Fatal Complication

Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture.

scholarly journals Key Issues in the Developing Synergism between Cardiovascular Imaging and Biomarkers

2008 ◽  
Vol 54 (9) ◽  
pp. 1432-1442 ◽  
Author(s):  
Allan S Jaffe
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
State Of The Art ◽  
Imaging Techniques ◽  
Cardiovascular Imaging ◽  
Cardiac Biomarkers ◽  
Chronic Ischemic Heart Disease ◽  
Content Areas ◽  
Combined Use ◽  
Key Issues

Abstract Background: Sophisticated methods of cardiac imaging have the potential to revolutionize the care of patients with cardiovascular disease. The benefits of these state-of-the art imaging techniques can be enhanced by their use in combination with new cardiac biomarkers. This review addresses potentially useful interactions between imaging and biomarkers. Content: Areas were defined in which the combined use of novel imaging techniques and biomarkers would be most beneficial. This review addresses multiple cardiovascular conditions for which the useful aspects of imaging and biomarkers are likely to be positively synergistic, including acute and chronic ischemic heart disease, heart failure, myocarditis, hypertension, and atherosclerosis. Conclusions: The synergistic use of imaging techniques and biomarkers will enhance the investigation of many key issues and questions and will be an important resource in the future.

scholarly journals A Prospective Study of Grip Strength Trajectories and Incident Cardiovascular Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Weida Liu ◽  
Runzhen Chen ◽  
Chenxi Song ◽  
Chuangshi Wang ◽  
Ge Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Grip Strength ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
A Prospective Study

Background: A single measurement of grip strength (GS) could predict the incidence of cardiovascular disease (CVD). However, the long-term pattern of GS and its association with incident CVD are rarely studied. We aimed to characterize the GS trajectory and determine its association with the incidence of CVD (myocardial infarction, angina, stroke, and heart failure).Methods: This study included 5,300 individuals without CVD from a British community-based cohort in 2012 (the baseline). GS was repeatedly measured in 2004, 2008, and 2012. Long-term GS patterns were identified by the group-based trajectory model. Cox proportional hazard models were used to examine the associations between GS trajectories and incident CVD. We identified three GS trajectories separately for men and women based on the 2012 GS measurement and change patterns during 2004–2012.Results: After a median follow-up of 6.1 years (during 2012–2019), 392 participants developed major CVD, including 114 myocardial infarction, 119 angina, 169 stroke, and 44 heart failure. Compared with the high stable group, participants with low stable GS was associated with a higher incidence of CVD incidence [hazards ratio (HR): 2.17; 95% confidence interval (CI): 1.52–3.09; P &lt;0.001], myocardial infarction (HR: 2.01; 95% CI: 1.05–3.83; P = 0.035), stroke (HR: 1.96; 95% CI: 1.11–3.46; P = 0.020), and heart failure (HR: 6.91; 95% CI: 2.01–23.79; P = 0.002) in the fully adjusted models.Conclusions: The low GS trajectory pattern was associated with a higher risk of CVD. Continuous monitoring of GS values could help identify people at risk of CVD.

scholarly journals Long-term body mass index changes in obese adults and the risk of heart failure, cardiovascular disease and mortality: a longitudinal study of 260,000 adults

2020 ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Increased Risk ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background: Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods: This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results: 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8kg/m 2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06kg/m 2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had a 3.3-fold increased risk of heart failure (HR 3.26 (95% CI 2.98-3.57)), 2.7-fold increased risk of all-cause mortality (HR 2.72 (2.58-2.87)) and 3.3-fold increased risk of CVD-related mortality (HR 3.31 (2.84-3.86)) after adjusting for baseline demographic and cardiovascular risk factors. Conclusion: The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

Estimating Long-Term Health Utility Scores and Expenditures for Cardiovascular Disease From the Medical Expenditure Panel Survey

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Jacob R. Morey ◽  
Shangqing Jiang ◽  
Sharon Klein ◽  
Wendy Max ◽  
Umesh Masharani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Ischemic Stroke ◽  
Angina Pectoris ◽  
Medical Expenditure Panel Survey ◽  
Short Form ◽  
Health Utility ◽  
Medical Expenditure ◽  
Utility Scores

Background: Long-term health utility scores and costs used in cost-effectiveness analyses of cardiovascular disease prevention and management can be inconsistent, outdated, or invalid for the diverse population of the United States. Our aim was to develop a user friendly, standardized, publicly available code and catalog to derive more valid long-term values for health utility and expenditures following cardiovascular disease events. Methods: Individual-level Short Form-12 version 2 health-related quality of life and expenditure data were obtained from the pooled 2011 to 2016 Medical Expenditure Panel Surveys. We developed code using the R programming language to estimate preference-weighted Short Form-6D utility scores from the Short Form-12 for quality-adjusted life year calculations and predict annual health care expenditures. Result predictors included cardiovascular disease diagnosis (myocardial infarction, ischemic stroke, heart failure, cardiac dysrhythmias, angina pectoris, and peripheral artery disease), sociodemographic factors, and comorbidity variables. Results: The cardiovascular disease diagnoses with the lowest utility scores were heart failure (0.635 [95% CI, 0.615–0.655]), angina pectoris (0.649 [95% CI, 0.630–0.667]), and ischemic stroke (0.649 [95% CI, 0.635–0.663]). The highest annual expenditures were for heart failure ($20 764 [95% CI, $17 500–$24 027]), angina pectoris ($18 428 [95% CI, $16 102–$20 754]), and ischemic stroke ($16 925 [95% CI, $15 672–$20 616]). Conclusions: The developed code and catalog may improve the quality and comparability of cost-effectiveness analyses by providing standardized methods for extracting long-term health utility scores and expenditures from Medical Expenditure Panel Survey data, which are more current and representative of the US population than previous sources.

Sign in / Sign up

Export Citation Format

Share Document