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Abstract
Modern effective methods of oncological diseases treatment allow to improve the survival of patients. However, the problem of antitumor therapy complications associated with toxic effect on the cardiovascular system is relevant. The first ESC Cardio-Oncology Guidelines 2022 was issued in 2022 by the European Society of Cardiology (ESC), was developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS): was developed by a Working Oncology Group on Cardio-Oncology of the European Society of Cardiology (ESC). Cardio-Oncology is a new interdisciplinary field, the goal of which is to improve the diagnosis, treatment and prevention of anticancer therapy cardiovascular complications. The first ESC Cardio-Oncology Guidelines 2022 presents a basic assessment of the anticancer drugs cardiovascular toxicity, the main methods of early diagnosis of complications. All decisions about the risk-benefit of cancer treatment are made based on the results of these methods. The guidelines include recommendations for primary and secondary prevention, treatment of cardiovascular complications and follow-up of patients receiving potentially cardiotoxic anticancer therapy. Risk stratification is based on factors of cardiovascular diseases, taking into account the side effects of anticancer drugs of different groups. The patients are divided into groups with low, moderate, high and very high risk according to this stratification. It is important to determine the treatment strategy. Based on the new protocols, recommendations for prevention and treatment are provided depending on the results of examinations, the presence or absence of the cardiovascular diseases, the anticancer drugs class and individual approach. The guidelines pay special attention to long-term, life-long monitoring of patients undergoing potentially cardiotoxic treatments.The appropriate strategy for planning a monitoring program was also developed. The Guidelines will allow doctors of various specialties to improve the care of cancer patients, to reduce potential cardiotoxic risks and to improve the quality of life of such patients. In this part of article, risk stratification of the cardiovascular complications development of anticancer therapy and strategies for their diagnosis and prevention are considered.
References
2. Čelutkienė J, Pudil R, López-Fernández T,Grapsa J, Nihoyannopoulos P, Bergler-Klein J, et al. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC). Eur J Heart Fail. 2020;22:1504-1524.
3. Curigliano G, Spitaleri G, Fingert HJ, de Braud F, Sessa C, Loh E et al. Drug-induced QTc interval prolongation: a proposal towards an efficient and safe anticancer drug development. Eur J Cancer. 2008;44:494-500.
4. Curigliano G, Lenihan D, Fradley M, Ganatra S, Barac A, Blaes A, et al. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Ann Oncol. 2020;31:171-190.
5. D’Ascenzi F, Anselmi F, Fiorentini C, Mannucci R, Bonifazi M, Mondillo S. The benefits of exercise in cancer patients and the criteria for exercise prescription in cardio-oncology. Eur J Prev Cardiol. 2021;28:725-735.
6. De Azambuja E, Procter MJ, Van Veldhuisen DJ, Agbor-Tarh D, Metzger-Filho O, Steinseifer J, et al. Trastuzumab-associated cardiac events at 8 years of median follow-up in the herceptin adjuvant trial (BIG 1-01). J Clin Oncol. 2014;32:2159-2165.
7. Fang K, Zhang Y, Liu W, He C. Effects of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use on cancer therapy-related cardiac dysfunction: a meta-analysis of randomized controlled trials. Heart Fail Rev. 2021;26:101-109.
8. Fardman A, Banschick GD, Rabia R, Percik R, Fourey D, Segev S, et al. Cardiorespiratory fitness and survival following cancer diagnosis. Eur J Prev Cardiol. 2021;28:1242-1249.
9. Fradley MG, Moslehi J. QT prolongation and oncology drug development. Card. 2015;7:341-355.
10. Galderisi M, Cosyns B, Edvardsen T, Cardim N, Delgado V, Di Salvo G, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2017;18:1301-1310.
11. Groarke JD, Payne DL, Claggett B, Mehra MR, Gong J, Caron J, et al. Association of post-diagnosis cardiorespiratory fitness with cause-specific mortality in cancer. Eur Heart J Qual Care Clin Outcomes. 2020;6:315-322.
12. Gupta S, Rohatgi A, Ayers CR, Willis BL, Haskell WL, Khera A, et al. Cardiorespiratory fitness and classification of risk of cardiovascular disease mortality. Circulation. 2011;123:1377-1383.
13. Hoffmann R, Barletta G, Von Bardeleben S, Vanoverschelde JL, Kasprzak J, Greis C, et al. Analysis of left ventricular volumes and function: a multicenter comparison of cardiac magnetic resonance imaging, cine ventriculography, and unenhanced and contrast-enhanced two-dimensional and three-dimensional echocardiography. J Am Soc Echocardiogr. 2014;27:292-301.
14. Holtermann A, Marott JL, Gyntelberg F, Søgaard K, Mortensen OS, Prescott E, et al. Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity — a prospective investigation in the Copenhagen City Heart Study. J Am Heart Assoc. 2015;4:e001495.
15. Huang S, Zhao Q, Yang ZG, Diao KY, He Y, Shi K, et al. Protective role of beta-blockers in chemotherapy-induced cardiotoxicity — a systematic review and meta-analysis of carvedilol. Heart Fail Rev. 2019;24:325-333.