Cardio-Oncology: Bridging the Gap Between Cardiovascular Health and Cancer Care

Hadi N Skouri

Division of Cardiology, Sheikh Shakbout Medical City-Mayo Clinic, Abu Dhabi, United Arab Emirates

DOI: https://doi.org/10.61706/MECOJ160134

Keywords: Cardio-oncology, Cardiotoxicity, Chemotherapy-Cardiotoxicity, Radiotherapy-Cardiotoxicity, Biomarkers

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Abstract

Cardio-oncology, an emerging subspecialty, is the study of the intersection of cardiovascular disease (CVD) and cancer. This field focuses on the prevention, diagnosis, and management of cardiovascular complications arising from cancer therapies. Given the increasing prevalence of cardiotoxicity induced by chemotherapy, targeted therapy, immunotherapy, and radiotherapy, this field plays a critical role in improving patient outcomes. Cardiotoxicity is characterized by a range of physiological manifestations, including cardiac dysfunction or heart failure, hypertension, arrhythmias, venous and arterial thromboembolism, pericardial disease, and pulmonary hypertension. Furthermore, the administration of certain pharmaceutical agents has been demonstrated to induce metabolic disturbances, which can manifest as an increased propensity for the development of diabetes or dyslipidemia, or the exacerbation of preexisting conditions. Chemotherapy-related cardiac dysfunction (CTRCD) manifests in two primary forms: type I, characterized by irreversible myocardial cell damage (e.g., anthracycline-induced cardiotoxicity), and type II, involving reversible myocardial dysfunction (e.g., trastuzumab-induced cardiotoxicity). Biomarkers, such as cardiac troponin (cTn) and natriuretic peptides (NP), play a pivotal role in the early detection of heart failure. Advanced imaging techniques, including cardiac MRI and speckle-tracking echocardiography, have been shown to enhance monitoring capabilities. Radiotherapy has been shown to have deleterious effects on cardiovascular health, contributing to the development of conditions such as coronary artery disease, valvular dysfunction, pericardial disease, and myocardial fibrosis. This review underscores the importance of multidisciplinary collaboration, early screening, and monitoring through innovative diagnostic tools to mitigate cardiovascular risks in cancer patients, ultimately enhancing survivorship and quality of life.

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