The Role of Echocardiography in the Cancer Patient
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ECHOCARDIOGRAPHY (JM GARDIN AND AH WALLER, SECTION EDITORS)
The Role of Echocardiography in the Cancer Patient Nicolas L. Palaskas 1
&
Juan Lopez-Mattei 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To review the uses of echocardiography in patients with cancer and how it has expanded beyond the typical monitoring of systolic function during potentially cardiotoxic cancer therapeutics. Recent Findings In addition to myocardial strain imaging being a predictor of subsequent left ventricular dysfunction, it can be used for pattern recognition to help identify patients with cardiac amyloidosis or Takotsubo cardiomyopathy. Echocardiography is essential for diagnosis and planning of intervention for aortic stenosis in radiation-induced valvular disease, for which transcutaneous aortic valve replacement that gives many cancer patients that are not surgical candidates an option for treatment. The safety of transesophageal echocardiography has recently been demonstrated in patients with cancer with thrombocytopenia and depleted white blood cell counts who are at increased risk of endocarditis. Summary Echocardiography is an essential tool for evaluating common conditions in cancer patients such as pericardial disease, radiation-induced heart disease, and intracardiac tumors—with specific uses of specialized echocardiography techniques such as deformation imaging, transesophageal echocardiography, and point-of-care ultrasound. Keywords Echocardiography . Cancer . Strain . Intracardiac tumor . Pericardial disease
Introduction Cardiovascular disease is a common comorbidity in patients with cancer, and cancer survivors have increased cardiovascular mortality [1]. There are numerous causes of cardiovascular disease (CVD) developing in patients with cancer. Several shared risk factors exist between cancer and CVD— including, but not limited to, tobacco use, obesity, and diabetes [2]. Cancer itself and cancer therapeutics also have various cardiac adverse effects, including left ventricular dysfunction and coronary artery disease [3]. Echocardiography has become an essential tool for evaluating and monitoring cardiovascular disease in patients with cancer. The portability, realtime image interpretation, relatively lower cost compared to This article is part of the Topical Collection on Echocardiography * Nicolas L. Palaskas [email protected] Juan Lopez-Mattei [email protected] 1
Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
other imaging modalities, and lack of radiation exposure make echocardiography the first choice cardiac imaging modality. There are several specific areas which will be reviewed below, in which echocardiography is especially useful for patients with cancer.
Left Ventricular Systolic Function Monitoring Many cancer therapeutics are known to cause left ventricular systolic dysfunction—most notably anthracyclines and human epidermal growth factor 2 (HER2) i
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