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- W2030257434 abstract "Together, cancer and cardiac disease are the leading causes of death in North America. 1 Centers for Disease Control. Deaths and mortality. 2013. Available at: http://www.cdc.gov/nchs/fastats/deaths.htm Google Scholar Recognizing this, in 2010 a group of oncologists saw the need for cardiologists and oncologists to work together and suggested that this interdisciplinary collaboration be termed “cardio-oncology” or “onco-cardiology.” 2 Albini A. Pennesi G. Donatelli F. Cammarota R. De Flora S. Noonan D.M. Cardiotoxicity of anticancer drugs: the need for cardio-oncology and cardio-oncological prevention. J Natl Cancer Inst. 2010; 102: 14-25 Crossref PubMed Scopus (573) Google Scholar Since then, this concept has evolved into a clinical discipline that focuses on the intersection of cardiac, oncologic, and hematologic disease. As a relatively young discipline, it has attracted a lot of recent attention. However, the need to understand this overlap between cancer and cardiovascular disease is not new but rather newly recognized, coinciding with the enhanced survival offered by modern cancer therapy. Acute as well as long-term cardiac sequelae of established and evolving cancer therapy are now both clinically apparent and relevant. Although cardiotoxicity associated with cancer therapy can include a variety of concerns, such as hypertension, ischemia, or arrhythmia, it is left ventricular (LV) dysfunction that has been a major focus of investigation in this area. After all, the latter is a clinical entity for which we have well-established diagnostic tools, such as echocardiography, along with a well-defined and validated therapeutic strategy in the form of angiotensin-converting enzymes and β-blockers. However, it is clear that overt LV dysfunction, as evidenced by a reduced ejection fraction (EF), is a rather late manifestation of cardiotoxicity. Therefore, more recent attention has focused on harnessing speckle-tracking echocardiography to evaluate myocardial mechanics, with global longitudinal strain (GLS) as an indicator of subclinical LV dysfunction. 3 Negishi K. Negishi T. Hare J.L. Haluska B.A. Plana J.C. Marwick T.H. Independent and incremental value of deformation indices for prediction of trastuzumab-induced cardiotoxicity. J Am Soc Echocardiogr. 2013; 26: 493-498 Abstract Full Text Full Text PDF PubMed Scopus (325) Google Scholar , 4 Thavendiranathan P. Poulin F. Lim K.D. Plana J.C. Woo A. Marwick T.H. Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review. J Am Coll Cardiol. 2014; 63: 2751-2768 Crossref PubMed Scopus (694) Google Scholar , 5 Sawaya H. Sebag I.A. Plana J.C. Januzzi J.L. Ky B. Tan T.C. et al. Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with athracyclines, taxanes and trastuzumab. Circ Cardiovasc Imaging. 2012; 5: 596-603 Crossref PubMed Scopus (560) Google Scholar Indeed, a recently published expert consensus document on the imaging evaluation of patients during and after cancer therapy, 6 Plana J.C. Galderisi M. Barac A. Ewer M.S. Ky B. Scherrer-Crosbie M. et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2014; 27: 911-939 Abstract Full Text Full Text PDF PubMed Scopus (804) Google Scholar defines cardiotoxicity as a symptomatic or asymptomatic decline in LV EF of >10% to a value < 53%. However, in addition to LV EF determination, this document also suggests incorporating GLS in the echocardiographic protocol, with a reduction in GLS of >15% from baseline being meaningful in a patient at risk for cardiotoxicity. Time Trends of Left Ventricular Ejection Fraction and Myocardial Deformation Indices in a Cohort of Women with Breast Cancer Treated with Anthracyclines, Taxanes, and TrastuzumabJournal of the American Society of EchocardiographyVol. 28Issue 5PreviewTrastuzumab, a HER2 monoclonal antibody, has transformed the prognosis of patients with the aggressive HER2-positive breast cancer type. Trastuzumab augments the cardiotoxic effects of anthracyclines, but its effect is thought to be at least partially reversible. The objective of this study was to examine the time trends of left ventricular (LV) size and function in a cohort of women treated with anthracyclines and trastuzumab. Full-Text PDF" @default.
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- W2030257434 title "Caring for the Cardio-Oncology Patient: Straining to Foresee the Future" @default.
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