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Review
. 2020 Nov 12;8(11):496.
doi: 10.3390/biomedicines8110496.

Cardiomyopathies and Arrhythmias Induced by Cancer Therapies

Dragoș-Mihai Romitan  1 , Dan Rădulescu  1 , Ioana Berindan-Neagoe  2 , Laurențiu Stoicescu  1 , Alin Grosu  1 , Liliana Rădulescu  1 , Diana Gulei  3 , Tudor-Eliade Ciuleanu  4
Affiliations
Review

Cardiomyopathies and Arrhythmias Induced by Cancer Therapies

Dragoș-Mihai Romitan et al. Biomedicines. .

Abstract

Cardiology and oncology are two fields dedicated to the study of various types of oncological and cardiac diseases, but when they collide, a new specialty is born, i.e., cardio-oncology. Continuous research on cancer therapy has brought into the clinic novel therapeutics that have significantly improved patient survival. However, these therapies have also been associated with adverse effects that can impede the proper management of oncological patients through the necessity of drug discontinuation due to life-threatening or long-term morbidity risks. Cardiovascular toxicity from oncological therapies is the main issue that needs to be solved. Proper knowledge, interpretation, and management of new drugs are key elements for developing the best therapeutic strategies for oncological patients. Upon continuous investigations, the profile of cardiotoxicity events has been enlarged with the inclusion of myocarditis upon administration of immune checkpoint inhibitors and cardiac dysfunction in the context of cytokine release syndrome with chimeric antigen receptor T cell therapy. Affinity enhanced and chimeric antigen receptor T cells have both been associated with hypotension, arrhythmia, and left ventricular dysfunction, typically in the setting of cytokine release syndrome. Therefore, the cardiologist must adhere to the progressing field of cancer therapy and become familiar with the adverse effects of novel drugs, and not only the ones of standard care, such as anthracycline, trastuzumab, and radiation therapy. The present review provides essential information summarized from the latest studies from cardiology, oncology, and hematology to bring together the three specialties and offers proper management options for oncological patients.

Keywords: arrhythmias; cardiomyocytes; cardiomyopathy; cardiotoxicity; chemotherapy; immunotherapy.

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Conflict of interest statement

Authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Risk factors that can induce cardiomyopathies.
Figure 2
Figure 2
Complementary investigations for diagnosing cardiotoxicity.
See this image and copyright information in PMC

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