Vascular Endothelial Growth Factor (VEGF) Inhibitor Cardiotoxicity: What Should We Know?
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(2020) 22:74
Cardio-oncology (M Fradley, Section Editor)
Vascular Endothelial Growth Factor (VEGF) Inhibitor Cardiotoxicity: What Should We Know? Teresa Lœpez-FernA˜ndez, MD, FICOS (Fellow of the International Cardio-Oncology Society)1,2,* AndrO˜s Daniele, MD3 Vanessa Gregorietti, MD4 Address 1 Cardio-Oncology Unit, Cardiology Department, La Paz University Hospital, IdiPAZ, CIBER CV, Madrid, Spain *,2 Servicio de Cardiología, Hospital Universitario La Paz, Hospital General Planta 1, Paseo de la Castellana 261, 28043, Madrid, Spain Email: [email protected] 3 Cardio-Oncology Department, Roffo Institute, Buenos Aires, Argentina 4 Heart Transplant Sanatorio Sagrado Corazon, Buenos Aires, Argentina
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Cardio-oncology Keywords VEGF I Cardiotoxicity I Cardio-oncology I Hypertension I Heart failure I Echocardiography
Abstract Purpose of review Cancer therapy-induced cardiovascular toxicity is a growing clinical problem with many unanswered questions about the optimal screening, prevention, and management, especially in patients treated with new targeted drugs. Among them, the use of vascular endothelial growth factor inhibitors (VEGFi) has become one of the most promising strategies to successfully approach a wide range of tumors. However, they have been associated with important cardiovascular complications such as systemic hypertension, heart failure, QTc prolongation, and venous and arterial thrombosis. This review addresses a multidisciplinary management of VEGFi-induced cardiotoxicity. Recent findings Optimal management of antiangiogenic drugs side effects is challenging due to limited evidence-based recommendations. The detection and aggressive treatment of hypertension and other cardiovascular risk factors is essential to minimize treatment interruptions, heart failure, and cardiac arrhythmias. Additionally a close monitoring of signs and symptoms that may raise the suspicion of venous or arterial thromboembolic events is recommended. For that purpose, cardio-oncology approach aims to facilitate cancer therapy and to promote cardio-oncology research. Summary VEFGi use is generally limited by uncontrolled hypertension that may trigger heart failure and cardiac arrhythmias. Therefore, a comprehensive cardio-oncology approach is needed to establish effective preventive and monitoring protocols.
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Curr Treat Options Cardio Med
(2020) 22:74
Introduction Cancer therapy-induced cardiovascular toxicity (CTox) is a growing clinical problem [1••, 2]. Cancer and cardiovascular diseases are connected by multiple pathophysiological mechanisms and common risk factors and, therefore, a multidisciplinary team approach is critical to stratify CTox risk and to reduce its impact on patients´ prognosis [3–5]. Classically heart failure (HF) has received greatest attention; however, the development of targeted therapies and the increased survival of many tumors have led to a higher percentage o
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