Biomarkers and Cancer Therapy-Related Cardiac Dysfunction
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HEART FAILURE PREVENTION (W. TANG, SECTION EDITOR)
Biomarkers and Cancer Therapy-Related Cardiac Dysfunction Prateek Sharma 1 & Mahin Rehman 1 & Javed Butler 1 & Michelle W. Bloom 1
Published online: 18 October 2016 # Springer Science+Business Media New York 2016
Abstract Cancer is a leading cause of morbidity and mortality, but improvements in therapy have translated to better outcomes. Despite this, patients exposed to certain cancer therapies may develop cardiac toxicity. Among cancer survivors, cardiovascular disease is currently the second leading cause of morbidity and mortality. The spectrum of cardiac disease is broad, including asymptomatic left ventricular dysfunction through cardiac failure, among other cardiovascular events. Novel imaging techniques such as speckle tracking/strain and three-dimensional echocardiogram are useful for evaluating cancer therapy-induced cardiotoxicity, but they are limited in clinical practice by local expertise and lack of widespread availability. There is no universally accepted imaging method or protocol for the identification of subclinical cardiotoxicity. The last several years have seen a growing exploration of serum cardiac biomarkers such as troponins, natruretic peptides, C-reactive protein, and others for the screening and monitoring of cancer therapy-associated cardiac dysfunction. This review examines recent literature surrounding the use of cardiac biomarkers for surveillance, diagnosis, and management of cardiac dysfunction related to cancer therapy, highlighting the limited data to support recommendations.
Keywords Biomarkers . Cardiotoxicity . Cardiac toxicity . Cancer . Chemotherapy . Anticancer therapy
This article is part of the Topical Collection on Heart Failure Prevention * Michelle W. Bloom [email protected] 1
Cardiology Division, Stony Brook University, Health Sciences Center, T-16, Room 080 SUNY, Stony Brook, NY 11794, USA
Introduction Cancer is one of the world’s leading causes of morbidity and mortality [1–4]. Despite this, the past three decades have seen a significant improvement in survival with enhanced early screening and detection, technological advancements, improved surgical techniques, and overall improvements in cancer therapy [1–4]. The 5-year survival for early-stage breast cancer increased from 79 % in 1990 to 88 % in 2012 and is comparable to improvements seen in other malignancies such as testicular cancer and non-Hodgkin lymphoma [1–6]. It is estimated that by 2022, there will be 18 million cancer survivors in the USA [7, 8]. With this growing population, however, comes a tangible increase in secondary consequences including cardiovascular compromise [7, 8]. Among cancer survivors, cardiovascular disease is currently the second leading cause of morbidity and mortality [2–5, 9]. Cardiovascular disease is the leading cause of mortality in breast cancer survivors over the age of 50 and also represents significant mortality of older survivors of all cancers [5, 6, 9, 10]. Current cancer therapies are associate
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