Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:1029-30 - Vol. 70 Num.11 DOI: 10.1016/j.rec.2017.07.004

Remarks on the Position Paper on Cardio-Onco-Hematology and Remarks on the Review of Cardiac Imaging Modalities for the Detection of Cardiotoxicity. Response

Teresa López-Fernández a,, Paaladinesh Thavendiranathan b, José Luis López-Sendón a, Juan Carlos Plana Gómez c

a Servicio de Cardiología, Unidad de Imagen Cardiaca, Unidad de Cardio-Oncología, Hospital Universitario La Paz, IdiPAz, Madrid, Spain
b Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
c Section of Cardiology, Baylor College of Medicine, Houston, Texas, United States

Refers to

Remarks on the Position Paper on Cardio-Onco-Hematology and Remarks on the Review of Cardiac Imaging Modalities for the Detection of Cardiotoxicity
Virginia Pubul, Irene Casáns, Santiago Aguadé, Francisco Javier de Haro
Rev Esp Cardiol. 2017;70:1028-9
Full text - PDF

Article

To the Editor,

Heart failure is one of the most concerning and best studied complications of antitumor treatments. Existing literature suggest that surveillance strategies are needed to promote early diagnosis at stages when cardiac dysfunction may be reversible with appropriate therapy.1, 2, 3 Regardless of the technique used for cancer treatment monitoring, it is clear that left ventricular ejection fraction alone is not sufficient to detect early myocardial injury.4 Current guidelines recommend echocardiography as the method of choice for the longitudinal follow-up of cancer patients.1, 2, 3

The main limitations of isotopic ventriculography are both the repeated use of radiation5 and the limited information on heart function. In fact, the high reproducibility of left ventricular ejection fraction measurements reported in the past is not available with current gamma cameras.1, 6

Echocardiography offers a complete evaluation of the heart (right ventricular function, atrial function, valvular and pericardial disease)7 and new echo techniques, particularly myocardial deformation imaging, allow for an early diagnosis of subclinical changes in cardiac function.8 Therefore, in daily practice, isotopic ventriculography is suggested only when echocardiography or cardiac-magnetic resonance imaging are not available and it has a low impact as an imaging technique for the diagnosis and prevention of cardiotoxicity.1, 2, 3, 6

Corresponding author: tlfernandez8@gmail.com

Bibliography

1. Plana JC, Galderisi M, Barac A, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the ASE and the EACVI. J Am Soc Echocardiogr. 2014;27:911-39.
2. Zamorano JL, Lancellotti P, Rodríguez Muñoz D, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur Heart J. 2016;37:2768-801.
3. Virani SA, Dent S, Brezden-Masley C, et al. Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer Therapy. Can J Cardiol. 2016;32:831-41.
4. Cardinale D, Colombo A, Bacchiani G, et al. Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. Circulation. 2015;131:1981-8.
5. Douglas PS, Carr JJ, Cerqueira MD, et al. Developing an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine. J Am Coll Cardiol. 2012;59:1833-47.
6. Huang H, Nijjar PS, Misialek JR, et al. Accuracy of left ventricular ejection fraction by contemporary multiple gated acquisition scanning in patients with cancer: comparison with cardiovascular magnetic resonance. J Cardiovasc Magn Resonance. 2017;19:34.
7. López-Fernández T, Martín García A, Santaballa Beltrán A, et al. Cardio-Onco-Hematology in Clinical Practice. Position Paper and Recommendations. Rev Esp Cardiol. 2017;70:474-86.
8. López-Fernández T, Thavendiranathan P. Emerging Cardiac Imaging Modalities for the Early Detection of Cardiotoxicity Due to Anticancer Therapies. Rev Esp Cardiol. 2017;70:487-95.

1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

Cookies
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.
Cookies policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.