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Multimodality Imaging in Cardiooncology.

Pizzino F, Vizzari G, Qamar R, Bomzer C, Carerj S, Zito C, Khandheria BK - J Oncol (2015)

Bottom Line: Anthracyclines and trastuzumab are the drugs most commonly associated with development of a cardiotoxic effect.However, left ventricular ejection decrease is a delayed phenomenon, occurring after a long stage of silent myocardial damage that classic imaging methods are not able to detect.New imaging techniques including three-dimensional echocardiography, speckle tracking echocardiography, and cardiac magnetic resonance have demonstrated high sensitivity in detecting the earliest alteration of left ventricular function associated with future development of chemotherapy-induced cardiomyopathy.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino" and Universita' degli Studi di Messina, Via Consolare Valeria No. 12, 98100 Messina, Italy.

ABSTRACT
Cardiotoxicity represents a rising problem influencing prognosis and quality of life of chemotherapy-treated patients. Anthracyclines and trastuzumab are the drugs most commonly associated with development of a cardiotoxic effect. Heart failure, myocardial ischemia, hypertension, myocarditis, and thrombosis are typical manifestation of cardiotoxicity by chemotherapeutic agents. Diagnosis and monitoring of cardiac side-effects of cancer treatment is of paramount importance. Echocardiography and nuclear medicine methods are widely used in clinical practice and left ventricular ejection fraction is the most important parameter to asses myocardial damage secondary to chemotherapy. However, left ventricular ejection decrease is a delayed phenomenon, occurring after a long stage of silent myocardial damage that classic imaging methods are not able to detect. New imaging techniques including three-dimensional echocardiography, speckle tracking echocardiography, and cardiac magnetic resonance have demonstrated high sensitivity in detecting the earliest alteration of left ventricular function associated with future development of chemotherapy-induced cardiomyopathy. Early diagnosis of cardiac involvement in cancer patients can allow for timely and adequate treatment management and the introduction of cardioprotective strategies.

No MeSH data available.


Related in: MedlinePlus

Three-dimensional echocardiography: evaluation of left ventricular ejection fraction in a normal patient (a) and in one with impaired function (b).
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Related In: Results  -  Collection


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fig1: Three-dimensional echocardiography: evaluation of left ventricular ejection fraction in a normal patient (a) and in one with impaired function (b).

Mentions: Real-time three-dimensional echocardiography can obtain a full-volume scan of the left ventricle, providing a quantification of volumes independently of geometrical assumptions. LVEF provided by RT-3DE (Figure 1) demonstrated elevated correlation with the values derived by cardiac magnetic resonance as shown in a study on 50 patients where Walker reported a correlation ranging from 0.90 to 0.97, while 2DE revealed a weak correlation (from 0.31 to 0.53) [15]. LVEF derived by RT-3DE showed the lower intraobserver and interobserver variability (0.017 and 0.027, resp.) and the best minimal detectable variation (4.8% intraobserver and 7.5% interobserver) [14].


Multimodality Imaging in Cardiooncology.

Pizzino F, Vizzari G, Qamar R, Bomzer C, Carerj S, Zito C, Khandheria BK - J Oncol (2015)

Three-dimensional echocardiography: evaluation of left ventricular ejection fraction in a normal patient (a) and in one with impaired function (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4537747&req=5

fig1: Three-dimensional echocardiography: evaluation of left ventricular ejection fraction in a normal patient (a) and in one with impaired function (b).
Mentions: Real-time three-dimensional echocardiography can obtain a full-volume scan of the left ventricle, providing a quantification of volumes independently of geometrical assumptions. LVEF provided by RT-3DE (Figure 1) demonstrated elevated correlation with the values derived by cardiac magnetic resonance as shown in a study on 50 patients where Walker reported a correlation ranging from 0.90 to 0.97, while 2DE revealed a weak correlation (from 0.31 to 0.53) [15]. LVEF derived by RT-3DE showed the lower intraobserver and interobserver variability (0.017 and 0.027, resp.) and the best minimal detectable variation (4.8% intraobserver and 7.5% interobserver) [14].

Bottom Line: Anthracyclines and trastuzumab are the drugs most commonly associated with development of a cardiotoxic effect.However, left ventricular ejection decrease is a delayed phenomenon, occurring after a long stage of silent myocardial damage that classic imaging methods are not able to detect.New imaging techniques including three-dimensional echocardiography, speckle tracking echocardiography, and cardiac magnetic resonance have demonstrated high sensitivity in detecting the earliest alteration of left ventricular function associated with future development of chemotherapy-induced cardiomyopathy.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino" and Universita' degli Studi di Messina, Via Consolare Valeria No. 12, 98100 Messina, Italy.

ABSTRACT
Cardiotoxicity represents a rising problem influencing prognosis and quality of life of chemotherapy-treated patients. Anthracyclines and trastuzumab are the drugs most commonly associated with development of a cardiotoxic effect. Heart failure, myocardial ischemia, hypertension, myocarditis, and thrombosis are typical manifestation of cardiotoxicity by chemotherapeutic agents. Diagnosis and monitoring of cardiac side-effects of cancer treatment is of paramount importance. Echocardiography and nuclear medicine methods are widely used in clinical practice and left ventricular ejection fraction is the most important parameter to asses myocardial damage secondary to chemotherapy. However, left ventricular ejection decrease is a delayed phenomenon, occurring after a long stage of silent myocardial damage that classic imaging methods are not able to detect. New imaging techniques including three-dimensional echocardiography, speckle tracking echocardiography, and cardiac magnetic resonance have demonstrated high sensitivity in detecting the earliest alteration of left ventricular function associated with future development of chemotherapy-induced cardiomyopathy. Early diagnosis of cardiac involvement in cancer patients can allow for timely and adequate treatment management and the introduction of cardioprotective strategies.

No MeSH data available.


Related in: MedlinePlus