AUTHOR=Mocan-Hognogi Diana Larisa , Trancǎ Sebastian , Farcaş Anca Daniela , Mocan-Hognogi Radu Florin , Pârvu Andrada Viorica , Bojan Anca Simona 

TITLE=Immune Checkpoint Inhibitors and the Heart

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.726426

DOI=10.3389/fcvm.2021.726426

ISSN=2297-055X

ABSTRACT=Immune checkpoint inhibitors (ICIs) represent  break-through treatment for a various number of cancers and their indication is continuously expanding. They are prescribed for primary tumors and for metastases, adjuvant and neoadjuvant therapy so there is an increased need for expertise in different aspects of the ICIs including the ways of response and toxicities related to them ICIs become toxic because of the removal of  self-tolerance, which in turn promotes autoimmune processes that affect every organ, but when related to the heart, it has been noticed  to be leading to acute heart failure and even death through various mechanisms (myocarditis, pericarditis, arrhythmia and Takotsubo cardiomyopathy) This review aims to address the above concerns by focusing on the latest findings on the topic, some insight on the mechanism of action of ICIs with special consideration regarding the myocardial tissue and providing information on clinical manifestation, diagnosis and (wherever possible) treatment of the cardiotoxic events related to this therapy. . The information is scarce and in most cases, the articles we found refer mainly to case-presentations and studies that were conducted on small populations, but we consider that it is worthwhile to be aware of it, , especially since this treatment is now widely used and it provides an important increase of the survival rate in patients who receive it.