Childhood cancer survivors: The integral role of the cardiologist and cardiovascular imaging - 16/08/20
, Jonathan H Soslow, MD, MSCI b, Justin Godown, MD b, Marcus F Stoddard, MD c, Evan C Osmundson, MD, PhD d, Carrie G Lenneman, MD, MSCI e, Debra L Friedman, MD f, Scott C Borinstein, MD, PhD fAbstract |
Importance |
With 80% of childhood cancer survivors (CCS) alive 30 years after diagnosis, preventable causes of death, such as cardiovascular disease resulting from initial cancer therapy, becomes an important metric. This leads to a more pronounced role for cardiologists in the care of CCS.
Observations |
While routine cardiovascular screening has been traditionally performed by the hematologist/oncologist or primary care provider, our understanding of cardiovascular disease in CCS has advanced. The measurement of left ventricular ejection fraction (LVEF) can now be complemented with additional assessments of strain, LV mass, right ventricular function, diastolic function, valve function, the pericardium, coronary perfusion, and biomarkers. Risk factor modification, prophylaxis, and timing of treatment are also critical.
Conclusions and Relevance |
Early cardiovascular screening and treatment in asymptomatic CCS can be nuanced and complex. As a result, there is a renewed opportunity for the cardiologist to play an integral role in the care of CCS.
Key Points |
Question/Purpose: Review cardiovascular disease and the role of the cardiologist in the care of asymptomatic childhood cancer survivors (CCS).
Findings: Cardiovascular care in CCS benefits from a multi-faceted approach that does not overly rely on LVEF.
Meaning: Adequate screening and treatment of cardiovascular disease in asymptomatic CCS may often be optimized by the involvement of a cardiologist.
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| Funding Sources: Research reported in this publication is supported by a To-morrow’s Research Fund St. Baldrick’s Scholar Award (Award Number 636214). The content is solely the responsibility of the authors and does not necessarily represent the official views of St. Baldricks. Disclosures: The authors report no conflicts of interest. "The authors are solely responsible for drafting and editing of the paper and its final contents." |
Vol 226
P. 127-139 - août 2020 Retour au numéro
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