The extensive use of chemotherapy in clinical practice has led to
considerable controversy due to their potential adverse cardiovascular effects in
surviving cancer patients. Among the effects of chemotherapeutic agents on the
cardiovascular system, the most frequent and serious is heart failure with ventricular
systolic dysfunction. Other harmful effects include hypertension, thromboembolic
disease, pericardial disease, arrhythmias and myocardial ischemia. Cancer therapyinduced
cardiomyopathy was almost exclusively associated with the use of cumulative
doses of anthracyclines. However, new therapeutic agents, such as the monoclonal
antibody trastuzumab, induce transient reversible myocyte dysfunction. Recent
research to limit cardiotoxicity has focused on early monitoring and risk stratification
to identify patients that are ‘at risk’ for cardiotoxicity, using biochemical markers and
the prophylactic use of novel cardioprotective agents. This chapter reviews the clinical
course, pathogenesis, cardiac monitoring and new concepts in diagnosing and
preventing chemotherapy cardiotoxicity.
Keywords: Anthracyclines, Cancer, Cardiomyopathy, Cardio-oncology, Cardiotoxicity,
Chemotherapy, Monitoring, Prevention, Radiotherapy, Trastuzumab.
