Owing to the improved developments in early-detection and therapeutics in cancer management over the previous decades, the number of cancer survivors (CS) has significantly increased. This trend continues to rise at a global scale. In this unique population group, Cardiovascular Disease (CVD) ranks as the second leading cause of death; various chemotherapy regimens and radiation therapy accelerate the development of CVD, such as coronary heart disease (CAD) and heart failure (HF). Similarly, patients in this group also present with increased risk factors for CVD, as a result of their poor lifestyle choice and the long-term metabolic effects of cancer therapies. In spite of this, current evidence suggests an under-recognition and treatment of CVD among CS. Limited data on using imaging parameters to predict long-term cardiac dysfunction exist, and the use of pharmacological/non-pharmacological strategies for the primary prevention in CS remains unavailable.
This Research Topic aims to understand the burden and pathophysiological basis of the problem. As the numbers of CS continue to rise, the incidences of CVD also increases; whether malignancy subtype, metabolic alterations, or genetic polymorphisms play a role in this, remains unclear. Moreover, emerging targeted therapies have proved to be useful in cancer therapy, though the long-term effects on the cardiovascular system remain unknown. Furthermore, the impact of quality of patients’ assistance on survival and CV outcomes should be clarified.
We also aim to highlight the use of multimodality imaging in predicting CV events. Conventional echocardiographic parameters routinely used for CS management often seem to not always adequately detecting early CV damage. Novel imaging techniques, including speckle tracking imaging, three-dimensional echocardiography and Cardiac Magnetic Resonance (CMR), have been investigated, but further studies are essential to elucidate their role in clinical practice. Moreover, observational studies on a limited number of patients suggest screening for CAD with Coronary Computed Tomography Angiography (CCTA) may be of utility. As well as highlighting tailored pharmacological/non-pharmacological strategies on patients’ individual CVD risk.
Sub topics include, but are not limited, to:
1) CVD incidence in CSs after conventional chemotherapy/radiation exposure, with a consideration of gender differences, individual susceptibility and cancer subtype.
2) Pathogenesis of CV sequelae in CS: metabolic alterations, genetic predispositions, and lifestyles.
3) Long-term outcomes of Primary Cardiac Tumors or Cardiac Metastasis.
4) Long-term CV effects of emerging oncological therapies, e.g. Proteasome Inhibitors, Immune Checkpoint Inhibitors, and Chimeric Antigen Receptor T-cell therapies.
5) Role of multimodality advanced imaging (echocardiography, CMR, CCTA) in risk-assessment and early-detection of CVD in CSs.
6) Preventive Cardio-Oncology; tailoring appropriate pharmacological/nonpharmacological strategies on patient's individual CVD risk.
7) The elderly CS: frailty assessment and optimal management.
8) CS Assistance quality; real-life experiences, cost-effectiveness, and future perspectives.
9) COVID-19 related modifications in CS management.
Owing to the improved developments in early-detection and therapeutics in cancer management over the previous decades, the number of cancer survivors (CS) has significantly increased. This trend continues to rise at a global scale. In this unique population group, Cardiovascular Disease (CVD) ranks as the second leading cause of death; various chemotherapy regimens and radiation therapy accelerate the development of CVD, such as coronary heart disease (CAD) and heart failure (HF). Similarly, patients in this group also present with increased risk factors for CVD, as a result of their poor lifestyle choice and the long-term metabolic effects of cancer therapies. In spite of this, current evidence suggests an under-recognition and treatment of CVD among CS. Limited data on using imaging parameters to predict long-term cardiac dysfunction exist, and the use of pharmacological/non-pharmacological strategies for the primary prevention in CS remains unavailable.
This Research Topic aims to understand the burden and pathophysiological basis of the problem. As the numbers of CS continue to rise, the incidences of CVD also increases; whether malignancy subtype, metabolic alterations, or genetic polymorphisms play a role in this, remains unclear. Moreover, emerging targeted therapies have proved to be useful in cancer therapy, though the long-term effects on the cardiovascular system remain unknown. Furthermore, the impact of quality of patients’ assistance on survival and CV outcomes should be clarified.
We also aim to highlight the use of multimodality imaging in predicting CV events. Conventional echocardiographic parameters routinely used for CS management often seem to not always adequately detecting early CV damage. Novel imaging techniques, including speckle tracking imaging, three-dimensional echocardiography and Cardiac Magnetic Resonance (CMR), have been investigated, but further studies are essential to elucidate their role in clinical practice. Moreover, observational studies on a limited number of patients suggest screening for CAD with Coronary Computed Tomography Angiography (CCTA) may be of utility. As well as highlighting tailored pharmacological/non-pharmacological strategies on patients’ individual CVD risk.
Sub topics include, but are not limited, to:
1) CVD incidence in CSs after conventional chemotherapy/radiation exposure, with a consideration of gender differences, individual susceptibility and cancer subtype.
2) Pathogenesis of CV sequelae in CS: metabolic alterations, genetic predispositions, and lifestyles.
3) Long-term outcomes of Primary Cardiac Tumors or Cardiac Metastasis.
4) Long-term CV effects of emerging oncological therapies, e.g. Proteasome Inhibitors, Immune Checkpoint Inhibitors, and Chimeric Antigen Receptor T-cell therapies.
5) Role of multimodality advanced imaging (echocardiography, CMR, CCTA) in risk-assessment and early-detection of CVD in CSs.
6) Preventive Cardio-Oncology; tailoring appropriate pharmacological/nonpharmacological strategies on patient's individual CVD risk.
7) The elderly CS: frailty assessment and optimal management.
8) CS Assistance quality; real-life experiences, cost-effectiveness, and future perspectives.
9) COVID-19 related modifications in CS management.