Comments on new 2022 European Society of Cardiology guidelines on cardiooncology

Zhenisgul Sh. Tlegenova, Saule K. Balmagambetova

Heart Vessels and Transplantation, 2023

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DOI 10.24969/hvt.2023.370
Data confidence 70 medium
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Abstract

Abbreviations ACE-I -angiotensin-Converting Enzyme Inhibitor ACS -acute coronary syndrome ARB -angiotensinReceptor Blocker CS-cancer survivors cTn -cardiac troponin CTRCD -cancer therapy-related cardiac dysfunction CTR-CVT -cancer therapy-related cardiovascular toxicity CVD -cardiovascular disease ECG -electrocardiogram ECHO -echocardiography GLS -global longitudinal strain HF -heart failure HFA-ICOS -heart Failure Association International Cardio-Oncology Society ICIs -immune checkpoint inhibitors LVEF -left ventricular ejection fraction MDT -multidisciplinary team QTcF-corrected QT interval using Fridericia correction RF -risk factor RT -Radiotherapy Emerging cardiovascular diseases (CVD) in cancer patients due to cancer therapy-related cardiovascular toxicity (CTR-CVT) take a significant proportion among causes of death in cancer survivors (CS) (1-3).CTR-CVT risk is a dynamic process, and the risk changes throughout the treatment course.CTR-CVT risk can be influenced by implementing primary prevention treatments, improving of pre-existing cardiovascular diseases treatment, dose, frequency, and duration of cancer treatment, and etc. Besides, the overall cumulative dose received, the time period since the cancer treatment was completed, and comorbidities may also impact on the risk (4).A recently published the first ESC cardio-oncology Guideline includes current definitions and principles of diagnosis and treatment, thus summarizing all the available evidence on cardio-oncology to assist health professionals in selecting the best management strategies for oncologic patients, considering the impact on the outcome, as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Cancer therapy-related cardiac dysfunction (CTRCD)CTRCD occurs in symptomatic and asymptomatic variants.Symptomatic CTRCD can be manifested in very severe form (need for inotropic support, mechanical circulatory support, or transplantation); severe (need for hospitalization due to developed heart failure (HF)); moderate (need for outpatient intensification of diuretic and HF therapy); and in mild form (mild HF symptoms, no need in intensification of HF therapy).