Risk determination, diagnosis and prevention of cardiotoxicity with chemotherapeutic medications and radiation therapy Guidelines of the Ukrainian Association of Cardiology

Main Article Content

V. M. Kovalenko
E. G. Nesukay


The recommendations were developed by the Ukrainian Association of Cardiology  based on the expert opinion and recommendation documents of the Heart Failure Association, the European Association of Cardiovascular Imaging (EACVI), the Cardiooncology Committee of the European Society of Cardiology (ESC),  European Society for Medical Oncology (ESMO), American Echocardiographic Society.  They focus on risk assessment, diagnostic and prophylactic approaches to reduce cardiovascular toxicity due to the use of chemotherapeutic drugs and radiation therapy in patients with cancer.  Intended  for cardiologists, therapists, family physicians, oncologists, researchers, teachers of higher medical education and postgraduate education.

Article Details


oncological diseases, cardiotoxicity, cardiovascular complications, chemotherapeutic drugs, radiation therapy


Amsallem M., Mercier O., Kobayashi Y. et al. Forgotten No More: A Focused Update on the Right Ventricle in Cardiovascular Disease // JACC Heart Fail.– 2018.– Vol. 6 (11).– P. 891–903. doi: https://doi.org/10.1016/j.jchf.2018.05.022.

Armenian S.H., Hudson M.M., Mulder R.L. et al.; International Late Effects of Childhood Cancer Guideline Harmonization Group. Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group // Lancet Oncol.– 2015.– Vol. (3).– P. 123–136. doi: https://doi.org/10.1016/S1470-2045(14)70409-7.

Campbell K.L., Winters-Stone K.M., Wiskemann J. et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable // Med. Sci Sports. Exerc.– 2019.– Vol. 51 (11).– P. 2375–2390. doi: https://doi.org/10.1249/MSS.0000000000002116.

Campia U., Moslehi J.J., Amiri-Kordestani L. et al. Cardio-Oncology: Vascular and Metabolic Perspectives: A Scientific Statement From the American Heart Association // Circulation.– 2019.– Vol. 139 (13).– P. 579–602. doi: https://doi.org/10.1161/CIR.0000000000000641.

Carver J.R., Shapiro C.L., Ng A. et al.; ASCO Cancer Survivorship Expert Panel. American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects // J. Clin. Oncol.– 2007.– Vol. 1 (25).– P. 3991–4008. doi: https://doi.org/10.1200/JCO.2007.10.9777.

Čelutkienė J., Pudil R., López-Fernández T. et al. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC) // Eur. J. Heart Fail.– 2020.– Vol. 4. doi: https://doi.org/10.1002/ejhf.1957.

Curigliano G., Lenihan D., Fradley M. et al.; Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations // Ann. Oncol.– 2020.– Vol. 31 (2).– P. 171–190. doi:https://doi.org/10.1016/j.annonc.2019.10.023.

Darby S.C., Cutter D.J., Boerma M. et al. Radiation-related heart disease: current knowledge and future prospects // Int. J. Radiat. Oncol. Biol. Phys.– 2010.– Vol. 76 (3).– P. 656–665. doi: https://doi.org/10.1016/j.ijrobp.2009.09.064.

Ferlay J., Steliarova-Foucher E., Lortet-Tieulent J. et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012 // Eur. J. Cancer.– 2013.– Vol. 49 (6).– P. 1374–403. doi: https://doi.org/10.1016/j.ejca.2012.12.027.

Ganatra S., Hayek S.S. Cardio-Oncology for GenNext: A Missing Piece of the Training Puzzle // J. Am. Coll. Cardiol.– 2018.– Vol. 71 (25).– P. 2977–2981. doi: https://doi.org/10.1016/j.jacc.2018.05.008.

Gilchrist S.C., Barac A., Ades P.A. et al.; American Heart Association Exercise, Cardiac Rehabilitation, and Secondary Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Peripheral Vascular Disease. Cardio-Oncology Rehabilitation to Manage Cardiovascular Outcomes in Cancer Patients and Survivors: A Scientific Statement From the American Heart Association // Circulation.– 2019.– Vol. 39 (21).– P. 997–1012. doi: https://doi.org/10.1161/CIR.0000000000000679.

Hayek S.S., Ganatra S., Lenneman C. et al. Preparing the Cardiovascular Workforce to Care for Oncology Patients: JACC Review Topic of the Week // J. Am. Coll. Cardiol.– 2019.– Vol. 73 (17).– P. 2226–2235. doi: https://doi.org/10.1016/j.jacc.2019.02.041.

Herrmann J., Lerman A., Sandhu N.P. et al. Evaluation and management of patients with heart disease and cancer: cardio-oncology // Mayo Clin. Proc.– 2014.– Vol. 89 (9).– P. 1287–1306. doi: https://doi.org/10.1016/j.mayocp.2014.05.013.

Jordan J.H., Todd R.M., Vasu S., Hundley W.G. Cardiovascular Magnetic Resonance in the Oncology Patient // JACC Cardiovasc. Imaging.– 2018.– Vol. 11 (8).– P. 1150–1172. doi: https://doi.org/10.1016/j.jcmg.2018.06.004.

Khouri M.G., Douglas P.S., Mackey J.R. et al. Cancer therapy-induced cardiac toxicity in early breast cancer: addressing the unresolved issues // Circulation.– 2012.– Vol. 126 (23).– P. 2749–2763. doi: https://doi.org/10.1161/CIRCULATIONAHA.112.100560.

Lancellotti P., Suter T.M., López-Fernández T. et al. Cardio-Oncology Services: rationale, organization, and implementation // Eur. Heart J.– 2019.– Vol. 40 (22).– P. 1756–1763. doi: https://doi.org/10.1093/eurheartj/ehy453.

Lang R.M., Addetia K., Narang A., Mor-Avi V. 3-Dimensional Echocardiography: Latest Developments and Future Directions // JACC Cardiovasс. Imaging.– 2018.– Vol. 11 (12).– P. 1854–1878. doi: https://doi.org/10.1016/j.jcmg.2018.06.024.

Liu J., Banchs J., Mousavi N. et al. Contemporary Role of Echocardiography for Clinical Decision Making in Patients During and After Cancer Therapy // JACC Cardiovasc. Imaging.– 2018.– Vol. 11 (8).– P. 1122–1131. doi: https://doi.org/10.1016/j.jcmg.2018.03.025.

López-Sendón J., Álvarez-Ortega C., Zamora Auñon P. et al.; on behalf of the CARDIOTOX Registry Investigators. Classification, prevalence, and outcomes of anticancer therapy-induced cardiotoxicity: the CARDIOTOX registry // Eur. Heart J.– 2020.– Vol. 41.– P. 1720–1729. doi: https://doi.org/10.1093/eurheartj/ehaa006.

Lyon A.R., Dent S., Stanway S. et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society // Eur. J. Heart Fail.– 2020.– Vol. 28. doi: https://doi.org/10.1002/ejhf.1920.

Manrique С.R., Park M., Tiwari N. et al. Diagnostic strategies for early recognition of cancer therapeutics-related cardiac dysfunction // Clin. Med. Insights. Cardiol.– 2017.– Vol. 11.– P. 1–12. doi: https://doi.org/10.1177/1179546817697.

Negishi K., Negishi T., Hare J.L. et al. Independent and incremental value of deformation indices for prediction of trastuzumab-induced cardiotoxicity // J. Am. Soc. Echocardiogr.– 2013.– Vol. 26 (5).– P. 493–498. doi: https://doi.org/10.1016/j.echo.2013.02.008.

Oikonomou E.K., Kokkinidis D.G., Kampaktsis P.N. et al. Assessment of prognostic value of left ventricular global longitudinal strain for early prediction of chemotherapy-induced cardiotoxicity. A systematic review and meta-analysis // JAMA Cardiol.– 2019.– Vol. 4 (10).– P. 1007–1018. doi: https://doi.org/10.1001/jamacardio.2019.2952.

Pareek N., Cevallos J., Moliner P. et al. Activity and outcomes of a cardio-oncology service in the United Kingdom-a five-year experience // Eur. J. Heart Fail.– 2018.– Vol. 20 (12).– P. 1721–1731. doi: https://doi.org/10.1002/ejhf.1292.

Pelliccia A., Sharma S., Gati S. et al.; ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease // Eur. Heart J.– 2020.– Vol. 29.– Р. 1–80. doi: https://doi.org/10.1093/eurheartj/ehaa605.

Plana J.C., Galderisi M., Barac A. et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echo­­­cardiography and the European Association of Cardiovascular Imaging // J. Am. Soc. Echocardiogr.– 2014.– Vol. 27 (9).– P. 911–939. doi: https://doi.org/10.1016/j.echo.2014.07.012.

Planek M.I.C., Manshad A., Hein K. et al. Prediction of doxorubicin cardiotoxicity by early detection of subclinical right ventricular dysfunction // Cardiooncology.– 2020.– Vol. 23 (6).– P. 10. doi: https://doi.org/10.1186/s40959-020-00066-8.

Ponikowski P., Voors A.A., Anker S.D. et al. Guidelines for the diagnosis and management heart failure // Eur. Heart J.– 2016.– Vol. 37.– P. 2129–2200. doi: https://doi.org/10.1093/eurheartj/ehw128.

Qi W.X., Shen Z., Tang L.N., Yao Y. Congestive heart failure risk in cancer patients treated with vascular endothelial growth factor tyrosine kinase inhibitors: a systematic review and meta-analysis of 36 clinical trials // Br. J. Clin. Pharmacol.– 2014.– Vol. 78 (4).– P. 748–762. doi: https://doi.org/10.1111/bcp.12387.

Santoro C., Esposito R., Lembo M. et al. Strain-oriented strategy for guiding cardioprotection initiation of breast cancer patients experiencing cardiac dysfunction // Eur. Heart J. Cardiovasc. Imaging.– 2019.– Vol. 20 (12).– P. 1345–1352. doi: https://doi.org/10.1093/ehjci/jez194.

Sanz А.Р., Zamorano J.L. «Cardiotoxicity»: time to define new targets? // Eur. Heart J.– 2020.– Vol. 41 (18).– P. 1730–1732. doi: https://doi.org/10.1093/eurheartj/ehaa013.

Squires R.W., Shultz A.M., Herrmann J. Exercise Training and Cardiovascular Health in Cancer Patients // Curr. Oncol. Rep.– 2018.– Vol. 20 (3).– P. 27. doi: https://doi.org/10.1007/s11912-018-0681-2.

Tadic M., Cuspidi C., Hering D. et al. The influence of chemotherapy on the right ventricle: did we forget something? // Clin. Cardiol.– 2017.– Vol. 40 (7).– P. 437–443. doi: https://doi.org/10.1002/clc.22672.

Tan L.L., Lyon A.R. Role of Biomarkers in Prediction of Cardiotoxicity During Cancer Treatment // Curr. Treat. Options Cardiovasc. Med.– 2018.– Vol. 20 (7).– P. 55. doi: https://doi.org/10.1007/s11936-018-0641-z.

Zamorano J.L., Lancellotti P., Rodriguez M.D. et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC) // Eur. Heart J.– 2016.– Vol. 21.– P. 2768–2801. doi: https://doi.org/10.1093/eurheartj/ehw211.

Zhang K.W., Finkelman B.S., Gulati G. et al. Abnormalities in 3-dimensional left ventricular mechanics with anthracycline chemotherapy are associated with systolic and diastolic dysfunction // JACC Cardiovasc. Imaging.– 2018.– Vol. 11 (8).– P. 1059–1068. doi: https://doi.org/10.1016/j.jcmg.2018.01.015.

Zhao R., Shu F., Zhang C. et al. Early detection and prediction of anthracyc Line-induced right ventricular cardiotoxicity by 3-dimensional echocardiography // JACC CardioOnc.– 2020.– Vol. 2 (1).– P. 13–22. doi: https://doi.org/10.1016/j.jaccao.2020.01.007.

Most read articles by the same author(s)

<< < 1 2