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Review
. 2015:2015:263950.
doi: 10.1155/2015/263950. Epub 2015 Aug 2.

Multimodality Imaging in Cardiooncology

Fausto Pizzino  1 , Giampiero Vizzari  1 , Rubina Qamar  2 , Charles Bomzer  2 , Scipione Carerj  1 , Concetta Zito  1 , Bijoy K Khandheria  3
Affiliations
Review

Multimodality Imaging in Cardiooncology

Fausto Pizzino et al. J Oncol. 2015.

Abstract

Cardiotoxicity represents a rising problem influencing prognosis and quality of life of chemotherapy-treated patients. Anthracyclines and trastuzumab are the drugs most commonly associated with development of a cardiotoxic effect. Heart failure, myocardial ischemia, hypertension, myocarditis, and thrombosis are typical manifestation of cardiotoxicity by chemotherapeutic agents. Diagnosis and monitoring of cardiac side-effects of cancer treatment is of paramount importance. Echocardiography and nuclear medicine methods are widely used in clinical practice and left ventricular ejection fraction is the most important parameter to asses myocardial damage secondary to chemotherapy. However, left ventricular ejection decrease is a delayed phenomenon, occurring after a long stage of silent myocardial damage that classic imaging methods are not able to detect. New imaging techniques including three-dimensional echocardiography, speckle tracking echocardiography, and cardiac magnetic resonance have demonstrated high sensitivity in detecting the earliest alteration of left ventricular function associated with future development of chemotherapy-induced cardiomyopathy. Early diagnosis of cardiac involvement in cancer patients can allow for timely and adequate treatment management and the introduction of cardioprotective strategies.

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Figures

Figure 1
Figure 1
Three-dimensional echocardiography: evaluation of left ventricular ejection fraction in a normal patient (a) and in one with impaired function (b).
Figure 2
Figure 2
Bull's eyes showing a decrease of global and regional strain in a patient before (a) and after (b) treatment with chemotherapy. In the same patient the left ventricular ejection fraction was not significantly altered (see also Supplementary Videos 3 and 4).
See this image and copyright information in PMC

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