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Getting to the Heart of the Matter: An Overview of Cardiac Toxicity Related to Cancer Therapy.

With the improvement in cancer survival, long-term cardiotoxicity has become an area of increased interest. Various cancer therapies, including chemotherapy and radiation therapy can lead to cardiac toxicities with both acute and chronic manifestations. Awareness and early recognition can lead to improvement in cardiac survival and patient outcomes. The focus of this review is to summarize the cancer therapy agents most often associated with cardiovascular side effects, highlighting their mechanism of action and strategies for surveillance and prevention.

Consensus Statement: Importance of Timely Access to Multiple Myeloma Diagnosis and Treatment in Central America and the Caribbean.

BackgroundIn Central America and the Caribbean, multiple myeloma (MM) patients face significant barriers to diagnosis and treatment. The aim of this study is to describe the current situation of MM in the region, discuss the current barriers to timely diagnosis and proper treatment, and develop consensus recommendations to address these issues.MethodsNine experts from five countries took part in a virtual consensus meeting on MM in Central America and the Caribbean. During the meeting, experts analyzed the disease burden, the current conditions for disease management, and access to treatment i

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… non-specificity of symptoms; lack of general knowledge about the disease or the role of hematologists; lack of timely access to medical specialists; and the absence of a multidisciplinary approach by a team that includes hematologists, oncologists, orthopedists, neurosurgeons, internists, nephrologists, cardiologists … The symptoms, characteristics, and possible complications associated with the disease often require a multidisciplinary approach, including a team of hematologists, oncologists, orthopedists, neurosurgeons, internists, nephrologists, cardiologists, psychiatrists, psychologists, and palliative care experts …

Real-World Data and Machine Learning to Predict Cardiac Amyloidosis.

(1) Background: Cardiac amyloidosis or "stiff heart syndrome" is a rare condition that occurs when amyloid deposits occupy the heart muscle. Many patients suffer from it and fail to receive a timely diagnosis mainly because the disease is a rare form of restrictive cardiomyopathy that is difficult to diagnose, often associated with a poor prognosis. This research analyses the characteristics of this pathology and proposes a statistical learning algorithm that helps to detect the disease. (2) Methods: The hospitalization clinical (medical and nursing ones) records used for this study are the ba

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… In order to identify the most commonly written terms in the evolutionary ones that could behave as red flags, two expert sessions were held in which a total of 8 geriatricians, internists, cardiologists, pharmacists and nurses participated. 2.3.1. … Diagnosis of Amyloidosis: A survey of current awareness and clinical challenges among cardiologists in Switzerland. Cardiol. Ther. 2020;9:127–138. doi: 10.1007/s40119-019-00160-8. 9. Gillmore J.D., Damy T., Ana M. …

Patient education in the management of coronary heart disease.

BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and improve prognosis. Cardiac rehabilitation is a complex multifaceted intervention which aims to improve the health outcomes of people with CHD. Cardiac rehabilitation consists of three core modalities: education, exercise training and psychological support. This is an update of a Cochrane systematic review previously published in 2011, which aims to investigate the spe

Guarding the heart in the era of immunotherapies: insights for cardio-oncology practice.

The advent of cancer immunotherapies, including immune checkpoint inhibitors (ICI), Chimeric antigen receptor (CAR-T) cell therapies, and bispecific antibodies and other immune-activating platforms such as therapeutic vaccines and oncolytic viruses (often used in combination regimens) has revolutionized oncology by improving patient outcomes across diverse malignancies. However, these therapies are increasingly linked to cardiovascular toxicities such as myocarditis, arrhythmias, and heart failure, posing significant clinical challenges. Here we review current evidence on the mechanisms, clini

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… By integrating existing data and recent advancements, this review aims to provide clinicians, oncologists, cardiologists, and researchers with a cohesive framework to navigate the complexities associated with immunotherapy-induced cardiovascular complications. … Through sustained interdisciplinary collaboration among oncologists, cardiologists, immunologists, imaging specialists, and basic scientists, we can preserve the remarkable therapeutic benefits of immunotherapy while safeguarding cardiovascular health. …

Heyde Syndrome Unveiled: A Case Report with Current Literature Review and Molecular Insights.

Heyde syndrome, marked by aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome, is often underreported. Shear stress from a narrowed aortic valve degrades von Willebrand factor multimers, leading to angiodysplasia formation and von Willebrand factor deficiency. This case report aims to raise clinician awareness of Heyde syndrome, its complexity, and the need for a multidisciplinary approach. We present a 75-year-old man with aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome type 2A. The patient w

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… The diagnostic approach for Heyde syndrome is multidisciplinary, involving gastroenterologists, hematologists, cardiologists, and cardiac surgeons. … He was discharged on Day 5 with a hemoglobin level of 86 g/L ( Table 1 ) and was prescribed oral iron and vitamin C supplementation, along with cardiologist-recommended therapy (angiotensin-converting enzyme inhibitor, beta-blockers, diuretics). …

Diagnosis and treatment of cardiac amyloidosis: an interdisciplinary consensus statement.

The prevalence and significance of cardiac amyloidosis have been considerably underestimated in the past; however, the number of patients diagnosed with cardiac amyloidosis has increased significantly recently due to growing awareness of the disease, improved diagnostic capabilities and demographic trends. Specific therapies that improve patient prognosis have become available for certain types of cardiac amyloidosis. Thus, the earliest possible referral of patients with suspicion of cardiac amyloidosis to an experienced center is crucial to ensure rapid diagnosis, early initiation of treatmen

The role of the PD-1/PD-L1 immune checkpoint pathway in myocardial infarction: a review from pathophysiological mechanisms to therapeutic strategies.

Programmed cell death protein 1 (PD-1) and its ligand, programmed death-ligand 1 (PD-L1), are vital molecules in immune checkpoints, significantly impacting cancer treatment. Recent studies have increasingly highlighted the complex roles of the PD-1/PD-L1 pathway in cardiovascular diseases, particularly in myocardial infarction (MI). In addition to being involved in immune modulation and the inflammatory response post-myocardial ischemia, this pathway is also crucial for myocardial repair and regeneration. Additionally, the clinical application of PD-1/PD-L1 immune checkpoint inhibitors has le

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… For example, patients receiving ICIs may experience immune-related adverse events, including myocarditis or myocardial infarction, which necessitate close monitoring and timely intervention by both cardiologists and oncologists ( 28 , 29 ). … Furthermore, ongoing communication between cardiologists and oncologists is essential for monitoring treatment responses and adjusting therapeutic strategies as needed. …

Persistent (patent) foramen ovale (PFO): implications for safe diving.

Diving medicine is a peculiar specialty. There are physicians and scientists from a wide variety of disciplines with an interest in diving a … senting with PFO-related DCI symptoms initially are declared "PFO-negative" by eminent, experienced cardiologists! Failing a prospective study, the risks of diving with a right-to left vascular shunt can only be expressed as an 'odds ratio', which is a less accurate measure than is 'relative risk'. The DAN Europe Carotid Doppler Study, started in 2001, is neari …

Cardiac toxicities in multiple myeloma: an updated and a deeper look into the effect of different medications and novel therapies.

With the continuous improvement in survival of cancer patients, including those with multiple myeloma, related to the novel treatment agents and therapeutic approaches, the probability for patients to develop cardiovascular disease has significantly increased, especially in elderly patients and those with additional risk factors. Multiple myeloma is indeed a disease of the elderly population and so these patients are, solely by age, at an increased risk of cardiovascular disease. Risk factors for these events can be patient-, disease- and/or therapy-related, and they have been shown to adverse

Case series discussion of cardiac and vascular events following carfilzomib treatment: possible mechanism, screening, and monitoring.

BackgroundCarfilzomib is a selective proteasome inhibitor approved in the United States in 2012 for the treatment of relapsed and refractory multiple myeloma. Although cardiopulmonary and vascular events have been reported infrequently, they can be potentially serious complications, and their incidence and pathophysiology following carfilzomib treatment remain poorly characterized in a real-world patient population.MethodsWe retrospectively reviewed the records of 67 patients with relapsed and/or refractory multiple myeloma treated at our institution.ResultsWe describe 12 patients who experien

Prevention of cancer-therapy related cardiac dysfunction.

PURPOSE OF REVIEW: Introduction of modern cancer therapies has led to increased survival of affected patients. With this advantage, the incidence of cancer therapy-related cardiac dysfunction (CTRCD) has increased and reasonable prevention strategies become necessary. This review outlines the major approaches to limit development and progression of CTRCD. RECENT FINDINGS: A broad range of cancer therapies can provoke CTRCD ranging from mild asymptomatic forms to severe heart failure. Profound cardiological assessment of cardiovascular comorbidities before initiation of cancer therapy allows i

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… Recent studies highlighted the complex interplay between cardiovascular conditions and cancer diseases, underscoring the importance of interdisciplinary cooperation of oncologists and cardiologists in cancer treatment plans [ 6 ]. … Discontinuation of cancer therapy depends on the level of CTRCD severity and relies on interdisciplinary decision between oncologists and cardiologists [ 4 , 96 ]. Therapy of CTRCD follows the guidelines for treatment of heart failure [ 26 ]. …

Amyloidosis: A story of how inframammary erosions eclipsed inconspicuous periorbital ecchymoses.

Systemic amyloidosis is a rare disease that can be rapidly progressive due to widespread organ involvement. There are well-described renal, cardiac, pulmonary, neurological, and dermatologic findings. Here, we outline one patient's experience with the condition from presentation to making the diagnosis. She presented with pathognomonic dermatologic findings including pinch purpura and ecchymoses found in the skin folds.

Research Communications of the 26th ECVIM‐CA Congress

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… | Saponaro | Cardiovascular effects of medetomidine alone or in combination with propofol in stage B2 mixomatous mitral valve disease 09.30–09.45 | ESVC‐O‐6 | Darnis | Inter‐observer agreement when measuring ultrasonographic inferior vena cava diameter and basic echocardiographic parameters by non cardiologist … A panel of three boarded cardiologists and one boarded diagnostic imager reviewed the abnormalities. Overall 8 dogs (1%) showed an anatomic anomaly. The most common anomaly was an aberrant retroesophageal right subclavian artery (n = 7, 0.8%). …

Status and Future Directions of Therapeutics and Prognosis of Cardiac Amyloidosis.

Accumulation of aberrant proteins in the heart causes cardiac amyloidosis, an uncommon and complicated illness. It can be classified into two main types: light chain (AL) and transthyretin (ATTR). The diagnosis of cardiac amyloidosis is challenging due to its non-specific clinical presentation and lack of definitive diagnostic tests. Diagnostic accuracy has increased with the advent of modern imaging methods, including cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. Depending on the severity of cardiac amyloidosis, a number of treatments may be attempted

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… Moreover, echocardiography/CMR should be conducted every 6 months and 24-hour Holter ECG, and a cardiologist should evaluate patients. On the other hand, blood parameters (including troponin and NT-proBNP), ECG, and neurological assessment (in cases with ATTRv) are recommended every 6 months. … AL amyloidosis for cardiologists: awareness, diagnosis, and future prospects: JACC: cardioOncology state-of-the-art review. JACC CardioOncol . 2022;4(4):427–441. doi: 10.1016/j.jaccao.2022.08.009 67. Mohty D, Damy T, Cosnay P, et al. Cardiac amyloidosis: updates in diagnosis and management. …

Micro- and Macrovascular Complications in Early-Onset Type 2 Diabetes in Indians: Prevalence and Predictors in a Prospective Cross-Sectional Study.

Introductionand Aims: The prevalence of T2DM is rising among young people, placing them at greater risk for complications. We studied the prevalence and predictors of micro- and macrovascular complications in early-onset diabetes subjects (EOD, MethodsA total of 800 subjects (400 EOD, 400 LOD), matched for gender and diabetes duration, were prospectively recruited and assessed for the prevalence of peripheral neuropathy, retinopathy, nephropathy, and ASCVD. Multivariate logistic regression analyzed predictors of diabetes complications.ResultsThe median age at diagnosis of diabetes was 35 years

Opportunities for shared decision-making about major surgery with high-risk patients: a multi-method qualitative study.

BackgroundLittle is known about the opportunities for shared decision-making when older high-risk patients are offered major surgery. This study examines how, when, and why clinicians and patients can share decision-making about major surgery.MethodsThis was a multi-method qualitative study, combining video recordings of preoperative consultations, interviews, and focus groups (33 patients, 19 relatives, 36 clinicians), with observations and documentary analysis in clinics in five hospitals in the UK undertaking major orthopaedic, colorectal, and/or cardiac surgery.ResultsThree opportunities f

Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies : Position paper of the Heart Failure Working Group of the Austrian Society of Cardiology.

Survival in cancer is continuously improving due to evolving oncological treatment. Therefore, cardiovascular short-term and long-term side effects gain crucial importance for overall outcome. Cardiotoxicity not only presents as heart failure, but also as treatment-resistant hypertension, acute coronary ischemia with plaque rupture or vasospasm, thromboembolism, arrhythmia, pulmonary hypertension, diastolic dysfunction, acute myocarditis and others. Recent recommendations have proposed baseline cardiac risk assessment and surveillance strategies. Major challenges are the availability of monito

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… Female adult survivors treated with cardiotoxic chemotherapy or chest radiation are strongly advised to consult a cardiologist before planning pregnancy and echocardiography and biomarkers should be considered [ 6 , 8 , 153 ]. … Cooperation of oncologists and cardiologists is mandatory to provide optimal care to patients with cancer and/or heart diseases and their follow-up in long-term survivors. …

Hereditary transthyretin amyloidosis presenting with carpal tunnel syndrome.

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Machine Learning Approaches in Diagnosis, Prognosis and Treatment Selection of Cardiac Amyloidosis.

Cardiac amyloidosis is an uncommon restrictive cardiomyopathy featuring an unregulated amyloid protein deposition that impairs organic function. Early cardiac amyloidosis diagnosis is generally delayed by indistinguishable clinical findings of more frequent hypertrophic diseases. Furthermore, amyloidosis is divided into various groups, according to a generally accepted taxonomy, based on the proteins that make up the amyloid deposits; a careful differentiation between the various forms of amyloidosis is necessary to undertake an adequate therapeutic treatment. Thus, cardiac amyloidosis is thou

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… Compared to cardiologists, automated HCM identification had a greater sensitivity in electrocardiography–echocardiography paired data analysis [ 67 ]. … Cardiologists still primarily use manual delineation in clinical settings to evaluate heart function, viability, and tissue characteristics [ 92 ]. An expert’s thorough manual analysis can take between 9 and 19 minutes, according to recent research [ 93 ]. …