Early Detection and Prediction of Cardiotoxicity - Biomarker and Echocardiographic Evaluation

In recent years with new anticancer therapies, many patients can have a long life expectancy. According to recently published data there are at present more than 12 million cancer survivors in the United States and in Europe (CDC, 2011; Coleman et al., 2003). These patients are prone to higher risk of cardiovascular death than the risk of tumor recurrence, particularly in childhood cancer survivors in which the cardiac mortality rate is sevenfold higher (Scully et al., 2007). However, cardiac toxicity remains an important side effect of anticancer therapies, leading to increased mortality due to mainly heart failure, but also myocardial ischemia, arrhythmias, hypertension, thromboembolism. The time from early development of cardiac dysfunction to the modification or end of chemotherapy and beginning of heart failure therapy, is an important determinant of the extent of recovery. Using conventional strategies with serial measurement of left ventricular ejection fraction, the time from first asymptomatic cardiac changes to clinical onset of cardiac dysfunction with heart failure may be lost for preventive therapy. This underlines the need for a realtime diagnosis of cardiac injury which represents the main goal for cardiologists and oncologists.