Abstract
Cardiovascular (CV) imaging is an important tool in baseline risk assessment and detection of CV disease in oncology patients receiving cardiotoxic cancer therapies. This position statement examines the role of echocardiography, cardiac magnetic resonance, nuclear cardiac imaging and computed tomography in the management of cancer patients. The Imaging and Cardio-Oncology Study Groups of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in collaboration with the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the ESC have evaluated the current evidence for the value of modern CV imaging in the cardio-oncology field. The most relevant echocardiographic parameters, including global longitudinal strain and three-dimensional ejection fraction, are proposed. The protocol for baseline pre-treatment evaluation and specific surveillance algorithms or pathways for anthracycline chemotherapy, HER2-targeted therapies such as trastuzumab, vascular endothelial growth factor tyrosine kinase inhibitors, BCr-Abl tyrosine kinase inhibitors, proteasome inhibitors and immune checkpoint inhibitors are presented. The indications for CV imaging after completion of oncology treatment are considered. The typical consequences of radiation therapy and the possibility of their identification in the long term are also summarized. Special populations are discussed including female survivors planning pregnancy, patients with carcinoid disease, patients with cardiac tumours and patients with right heart failure. Future directions and ongoing CV imaging research in cardio-oncology are discussed.
| Original language | English |
|---|---|
| Pages (from-to) | 1504-1524 |
| Number of pages | 21 |
| Journal | European Journal of Heart Failure |
| Volume | 22 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 1 Sept 2020 |
| Externally published | Yes |
Bibliographical note
Funding Information:: J.C. received personal fees from AstraZeneca, Novartis, Roche, Servier, Amgen, Berlin‐Chemie, Grindex. R.P. received personal fees from Novartis, Roche, Servier and MSD. T.L.F. received speaker fees from Pfizer, Servier, Amgen, Janssens‐Cilag Ltd, Daiichi‐Sankyo, MSD, and Philips. D.F. received consultation fees, speaker honoraria and/or travel grants from Abbott Laboratories, Boehringer Ingelheim, Daiichi Sankyo, Menarini, Novartis, Pfizer, Roche Diagnostics and Servier. The UMCG, which employs Dr. de Boer, has received research grants and/or fees from AstraZeneca, Abbott, Bristol‐Myers Squibb, Novartis, NovoNordisk, and Roche. R.A.d.B. is a minority shareholder of scPharmaceuticals, Inc.; and received personal fees from Abbott, AstraZeneca, MandalMed Inc, and Novartis. C.B.D. is in part supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. M.S.A. received personal fees from Servier. M.G. received advisory board fees from Pfizer, Bayer, Sobi. C.M. received research support from the Swiss National Science Foundation, the Swiss Heart Foundation, the KTI, the Stiftung für kardiovaskuläre Forschung Basel, the University of Basel, the University Hospital Basel, Abbott, Beckman Coulter, Brahms, Novartis, Ortho Clinical Diagnostics, Quidel, Roche, Siemens, Singulex, Sphingotec, as well as speaker/consulting honoraria from Acon, Amgen, AstraZeneca, Boehringer Ingelheim, BMS, Idorsia, Novartis, Roche, Sanofi, and Singulex. The APHP, which employs J.S.H., received research grants from Bioserenity, Sanofi, Servier and NovoNordisk. J.S.H. received speaker, advisory board or consultancy fees from Amgen, AstraZeneca, Bayer, Bristol‐Myers Squibb, Novartis, WeHealth. B.M. received personal fees from Servier, Novartis, Boehringer Ingelheim, Eli Lilly, AstraZeneca, BMS, Merck Serono, and consultancy fees from Novartis and Boehringer Ingelheim. P.S. received lecture and consultancy agreement honoraria from Medtronic, Abbott, Servier, AstraZeneca, Respicardia, Boehringer Ingelheim, Novartis. A.R.L. received speaker, advisory board or consultancy fees and/or research grants from Pfizer, Novartis, Servier, Amgen, Takeda, Roche, Janssens‐Cilag Ltd, Clinigen Group, Eli Lilly, Eisai, Bristol‐Myers Squibb, Ferring Pharmaceuticals and Boehringer Ingelheim. Conflict of interest
Funding Information:
R.A.d.B. is supported by the Netherlands Heart Foundation (CVON DOSIS, grant 2014-40, CVON SHE-PREDICTS-HF, grant 2017-21, and CVON RED-CVD, grant 2017-11), and the European Research Council (ERC CoG 818715, SECRETE-HF). C.G.T. is supported by a Federico II University/Ricerca di Ateneo grant. Conflict of interest: J.C. received personal fees from AstraZeneca, Novartis, Roche, Servier, Amgen, Berlin-Chemie, Grindex. R.P. received personal fees from Novartis, Roche, Servier and MSD. T.L.F. received speaker fees from Pfizer, Servier, Amgen, Janssens-Cilag Ltd, Daiichi-Sankyo, MSD, and Philips. D.F. received consultation fees, speaker honoraria and/or travel grants from Abbott Laboratories, Boehringer Ingelheim, Daiichi Sankyo, Menarini, Novartis, Pfizer, Roche Diagnostics and Servier. The UMCG, which employs Dr. de Boer, has received research grants and/or fees from AstraZeneca, Abbott, Bristol-Myers Squibb, Novartis, NovoNordisk, and Roche. R.A.d.B. is a minority shareholder of scPharmaceuticals, Inc.; and received personal fees from Abbott, AstraZeneca, MandalMed Inc, and Novartis. C.B.D. is in part supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. M.S.A. received personal fees from Servier. M.G. received advisory board fees from Pfizer, Bayer, Sobi. C.M. received research support from the Swiss National Science Foundation, the Swiss Heart Foundation, the KTI, the Stiftung für kardiovaskuläre Forschung Basel, the University of Basel, the University Hospital Basel, Abbott, Beckman Coulter, Brahms, Novartis, Ortho Clinical Diagnostics, Quidel, Roche, Siemens, Singulex, Sphingotec, as well as speaker/consulting honoraria from Acon, Amgen, AstraZeneca, Boehringer Ingelheim, BMS, Idorsia, Novartis, Roche, Sanofi, and Singulex. The APHP, which employs J.S.H., received research grants from Bioserenity, Sanofi, Servier and NovoNordisk. J.S.H. received speaker, advisory board or consultancy fees from Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Novartis, WeHealth. B.M. received personal fees from Servier, Novartis, Boehringer Ingelheim, Eli Lilly, AstraZeneca, BMS, Merck Serono, and consultancy fees from Novartis and Boehringer Ingelheim. P.S. received lecture and consultancy agreement honoraria from Medtronic, Abbott, Servier, AstraZeneca, Respicardia, Boehringer Ingelheim, Novartis. A.R.L. received speaker, advisory board or consultancy fees and/or research grants from Pfizer, Novartis, Servier, Amgen, Takeda, Roche, Janssens-Cilag Ltd, Clinigen Group, Eli Lilly, Eisai, Bristol-Myers Squibb, Ferring Pharmaceuticals and Boehringer Ingelheim.
Funding Information:
R.A.d.B. is supported by the Netherlands Heart Foundation (CVON DOSIS, grant 2014‐40, CVON SHE‐PREDICTS‐HF, grant 2017‐21, and CVON RED‐CVD, grant 2017‐11), and the European Research Council (ERC CoG 818715, SECRETE‐HF). C.G.T. is supported by a Federico II University/Ricerca di Ateneo grant.
Publisher Copyright:
© 2020 European Society of Cardiology
