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Detection and monitoring of cardiotoxicity—what does modern cardiology offer?

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Abstract

Introduction

With new anticancer therapies, many patients can have a long life expectancy. Treatment-related comorbidities become an issue for cancer survivors. Cardiac toxicity remains an important side effect of anticancer therapies. Myocardial dysfunction can become apparent early or long after end of therapy and may be irreversible. Detection of cardiac injury is crucial since it may facilitate early therapeutic measures. Traditionally, chemotherapy-induced cardiotoxicity has been detected by measuring changes in left ventricular ejection fraction. This parameter is, however, insensitive to subtle changes in myocardial function as they occur in early cardiotoxicity.

Discussion

This review will discuss conventional and modern cardiologic approaches of assessing myocardial function. It will focus on Doppler myocardial imaging, a method which allows to sensitively measure myocardial function parameters like myocardial velocity, deformation (strain), or deformation rate (strain rate) and which has been shown to reliably detect early abnormalities in both regional and global myocardial function in an early stage.Other newer echocardiographic function estimators are based on automated border detection algorithms and ultrasonic integrated backscatter analysis. A further technique to be discussed is dobutamine stress echocardiography. The use of new biomarkers like B-type natriuretic peptide and troponin and less often used imaging techniques like magnetic resonance imaging and computed tomography will also be mentioned.

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Authors and Affiliations

  1. Department of Cardiology, University Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium

    Ruxandra Jurcut, Javier Ganame, Jan D’hooge & Jens-Uwe Voigt

  2. General Medical Oncology—Multidisciplinary Breast Centre, University Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium

    Hans Wildiers & Robert Paridaens

  3. Department of Cardiology, Institute of Cardiovascular Diseases, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

    Ruxandra Jurcut

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  1. Ruxandra Jurcut
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  2. Hans Wildiers
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  3. Javier Ganame
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  4. Jan D’hooge
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  6. Jens-Uwe Voigt
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Correspondence to Jens-Uwe Voigt.

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Jurcut, R., Wildiers, H., Ganame, J. et al. Detection and monitoring of cardiotoxicity—what does modern cardiology offer?. Support Care Cancer 16, 437–445 (2008). https://doi.org/10.1007/s00520-007-0397-6

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