Cardio-oncología y cardiotoxicidad

Abstract

Cardio-oncology is a discipline that takes a comprehensive approach to cardiovascular disease in the cancer patient, in the presence of active cancer and in surviving patients. The modern concept of cardiotoxicity encompasses not only ventricular dysfunction and heart failure, but all toxic effects causing ischaemic heart disease, arrhythmias, systemic and pulmonary arterial hypertension, valvular heart disease, myocarditis, pericardial and thromboembolic disease. Cardiac imaging is the main tool for diagnosing and monitoring cardiovascular toxicity, and is complemented using biomarkers of myocardial injury. Management of toxic effects is based on the control of cardiovascular risk factors and heart-healthy lifestyles, introduction of heart failure drugs in the event of impaired ventricular function, and multidisciplinary assessment of the discontinuation of cancer treatment or use of alternative regimens, as well as cardioprotectors or less cardiotoxic formulations. After anti-tumour treatment has been completed, long-term cardiotoxicity surveillance should be continued in most patients, and and schedules for long-term follow-up of survivors are necessary.