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Review
. 2025 Feb;31(2):415-455.
doi: 10.1016/j.cardfail.2024.08.045. Epub 2024 Oct 15.

Cardio-Oncology and Heart Failure: a Scientific Statement From the Heart Failure Society of America

Michelle Weisfelner Bloom  1 , Jacqueline B Vo  2 , Jo E Rodgers  3 , Alana M Ferrari  4 , Anju Nohria  5 , Anita Deswal  6 , Richard K Cheng  7 , Michelle M Kittleson  8 , Jenica N Upshaw  9 , Nicolas Palaskas  10 , Anne Blaes  11 , Sherry-Ann Brown  12 , Bonnie Ky  13 , Daniel Lenihan  14 , Mathew S Maurer  15 , Anecita Fadol  16 , Kerry Skurka  17 , Christine Cambareri  18 , Cynthia Chauhan  19 , Ana Barac  20
Affiliations
Review

Cardio-Oncology and Heart Failure: a Scientific Statement From the Heart Failure Society of America

Michelle Weisfelner Bloom et al. J Card Fail. 2025 Feb.

Abstract

Heart failure and cancer remain 2 of the leading causes of morbidity and mortality, and the 2 disease entities are linked in a complex manner. Patients with cancer are at increased risk of cardiovascular complications related to the cancer therapies. The presence of cardiomyopathy or heart failure in a patient with new cancer diagnosis portends a high risk for adverse oncology and cardiovascular outcomes. With the rapid growth of cancer therapies, many of which interfere with cardiovascular homeostasis, heart failure practitioners need to be familiar with prevention, risk stratification, diagnosis, and management strategies in cardio-oncology. This Heart Failure Society of America statement addresses the complexities of heart failure care among patients with active cancer diagnoses and cancer survivors. Risk stratification, monitoring and management of cardiotoxicity are presented across stages A through D heart failure, with focused discussion on heart failure with preserved ejection fraction and special populations, such as survivors of childhood and young-adulthood cancers. We provide an overview of the shared risk factors between cancer and heart failure, highlighting heart failure as a form of cardiotoxicity associated with many different cancer therapeutics. Finally, we discuss disparities in the care of patients with cancer and cardiac disease and present a framework for a multidisciplinary-team approach and critical collaboration among heart failure, oncology, palliative care, pharmacy, and nursing teams in the management of these complex patients.

Keywords: Heart failure; and social determinants; bone marrow/stem cell transplant; cancer; cancer survivorship; cancer treatment-related cardiac dysfunction; cardio-oncology; cardiomyopathy; cardiotoxicity; health disparities; heart failure with preserved ejection fraction; heart failure with reduced ejection fraction; mechanical circulatory support; multidisciplinary care; myocarditis; palliative care; pregnancy; pulmonary hypertension; stress cardiomyopathy.

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Conflict of interest statement

Disclosures MWB reports compensation for serving as faculty or as a speaker for a medical education program and consulting fees for Astra Zeneca. AN receives research support from Bristol Myers Squibb and consulting fees from AstraZeneca and Takeda Oncology. AD reports being a consultant for Bayer. NP reports support from the Cancer Prevention & Research Institute of 23 Texas (CPRIT) RP200670, NIH/NCI 1P01CA261669-01, Andrew Sabin Family Foundation, Replimmune, and Kiniksa. Pharmaceuticals. BK reports consulting for Astra Zeneca, Roche, BMS, IIS, and Pfizer. DL reports consultant fees from Myocardial Solutions, Clementia, OncXerna, AstraZeneca, Roche, SecuraBio, Intellia and Novo-Nordisk. MSM reports grant support from NIH R01HL139671, 1R01AG081582-01 and grants and personal fees from Attralus, Alnylam, Pfizer, Eidos, and Ionis, and personal fees from Astra Zeneca and Intellia. AB reports consulting fees for Astra Zeneca. All other authors report no disclosures.

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