Cardiac Management of Oncology Patients

1. Front Matter

   Pages i-ix

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2. Introduction

   • Riccardo Asteggiano, Gonzalo Baron Esquivias

   Pages 1-21

3. Physiopathology and Toxic Heart Effects of Chemotherapy Drugs

   • Riccardo Asteggiano

   Pages 23-97

4. Radiotherapy Heart Effects

   • Riccardo Asteggiano

   Pages 99-127

5. Cardiac Imaging Technology in Cardio-oncology

   • Christopher Tillmanns

   Pages 129-155

6. Evaluation of the Oncologic Patient Before, During, and After Chemotherapy

   • Iris Parrini, Alessandro Bonzano

   Pages 157-186

7. Specific Clinic Problems in Cancer Therapy Cardiac Toxicity Complications

   • Iris Parrini, Alessandro Bonzano, Gonzalo Baron Esquivias, Xavier Garcia-Moll

   Pages 187-235

8. Synthetic Tables

   • Iris Parrini, Alessandro Bonzano

   Pages 237-252

9. Back Matter

   Pages 253-259

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This book is designed for clinical cardiologists and other physicians working with cardiac patients, where specific specialized teams of cardio-oncologists are not available and who are called to perform a clinical consultation to evaluate both the cardiac condition and the eligibility for chemotherapy or radiotherapy treatment, and to evaluate if a cancer treatment produces toxic effects on a patient treated with chemo or radiotherapy and if appearance of new symptoms is due to this treatment. In recent years, progress in oncologic therapy has resulted in important developments and the prognostic improvement of patients with malignancy. The cornerstone of chemotherapy are the anthracyclines (and the analogue Mitoxantrone), that are direct cellular toxic agents and that are among the most powerful anti-neoplastic drugs, but their cardiac toxicity is well known. Significant breakthroughs in cancer therapy have also been achieved with the introduction of signalling inhibitors, such as VEGF inhibitors, HERB2 inhibitors or TK inhibitors used alone or in combination with direct cellular toxic drugs. However, these signalling inhibitors may interact also with cardiovascular signalling and therefore may have functional or structural effects on the myocardium. This can be permanent or reversible, with impairment of the global conditions and important side effects, and increase both morbidity and mortality and worsening of quality of life. Chemotherapy and radiotherapy can have acute detrimental effects that can be present for years after treatment and that can lead to cardiac consequences also after long periods of no clinic sequelae. Patient numbers with cancer problems will dramatically increase in the next years and thus every cardiologist will need to have the correct information and the skills to manage these situations in the correct way. This book will provide these tools for them.

• Anthracyclines
• Cardio-Oncology
• Cardiotoxicity
• Chemotherapy
• Radiotherapy
• Radiaton Oncology

• Cardiology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain

  Gonzalo Baron Esquivias

• Azienda Sanitaria Locale Torino 3, Out of Hospital Cardiology Service, Torino, Italy

  Riccardo Asteggiano

Gonzalo Baron Esquivias is a member of Spanish Society of Cardiology since 1994 and its former Treasurer during 2008-2009. I have been admitted as Fellow of the European Society of Cardiology in August 2003. Actually I am formal President of Clinical Cardiology Section from Spanish Society of Cardiology and formal President of Council for Cardiology Practice of European Society of Cardiology. Riccardo Asteggiano is a member of the Council of Health District 4 of the Local Sanitary Agency Torino 3 and member of the Nucleus of the Council of Cardiology Practice of the European Society of Cardiology for the years 2008-2010 and Treasurer for the years 2010-2014. Member of the Heart Failure Association of the European Society of Cardiology. Founding Member of the Italian Cardiology Association “Collegio Federativo di Cardiologia”. Past-President of regional chapter for the Piedmont of the Italian National Association of Cardiologist in Practice (ANCE) and member of the Heart Failure WG of this association. Founding Member of the Cardiology Department of the Local Sanitary Agency Torino 2. Consultant Cardiologist of the Regional School for General Practice of the Regione Piemonte. Speaker and Author of many presentations and posters in regional, national and European Congresses of Cardiology in the flied of arrhythmias, anticoagulation, heart failure, clinic cardiology.

Policies and ethics