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Cardio-Oncology

Principles, Prevention and Management

1st Edition - November 26, 2016

Authors: Roberta A. Gottlieb, Puja K Mehta

Hardback ISBN:

9 7 8 - 0 - 1 2 - 8 0 3 5 4 7 - 4

eBook ISBN:

9 7 8 - 0 - 1 2 - 8 0 3 5 5 3 - 5

Cardio-Oncology: Principles, Prevention and Management is a clinical volume that focuses on the basic science of cardio-oncology, addresses cardiotoxicity as a consequence of… Read more

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Cardio-Oncology: Principles, Prevention and Management is a clinical volume that focuses on the basic science of cardio-oncology, addresses cardiotoxicity as a consequence of cancer therapy, and discusses prevention, diagnosis and management of cardiovascular disease in patients with cancer.

This comprehensive volume presents unique perspectives ranging from basic science to clinical medicine in the field of cardio-oncology. It would be a valuable resource for cardiologists, oncologists, internists, and pediatricians caring for patients with cancer who have cardiovascular risk factors, as well as for cardio-oncology researchers.

Foreword
List of Contributors
Acknowledgments
Chapter 1: Current Trends in Cancer Therapy
- Abstract
- PI3K/AKT pathway
- mTOR pathway
- Mitogen-activated protein kinase (MAPK) pathway
- EGFR pathway
- Human epidermal growth factor receptor 2
- Anaplastic lymphoma kinase pathway
- Antiangiogenic agents
- VEGF pathway
- Immunotherapy
- Cyclin dependent kinases and their pathways
- Poly ADP ribose polymerase inhibition
- Conclusions
Chapter 2: Molecular Mechanisms Underlying Anthracycline Cardiotoxicity: Challenges in Cardio-Oncology
- Abstract
- Introduction
- Impaired redox signaling
- Iron overload in mitochondria
- Calcium overload in mitochondria
- Altered mitochondrial dynamics in anthracyclines
- Respiratory defects and altered metabolism in anthracycline cardiotoxicity
- Autophagy in anthracycline cardiotoxicity
- Deregulated molecular signaling pathways in anthracycline cardiotoxicity
- Gender-specific cardiotoxic effects of anthracycline
- Anthracyclines and cardiac remodeling
- Strategies to prevent doxorubicin cardiotoxicity
- Conclusions
Chapter 3: Common Pathways in Cancer, Tumor Angiogenesis and Vascular Disease
- Abstract
- Introduction
- Hedgehog signaling
- Notch signaling
- Vascular targets for chemotherapy—angiogenesis
- Vascular targets for chemotherapy—vasculogenic mimicry
- Vascular targets for chemotherapy—microvesicular trafficking
- Vascular targets for chemotherapy—vessel maturation
- Hedgehog and cancer biology
- Hedgehog inhibitors in cancer therapy
- Hedgehog and vascular biology
- Notch signaling and tumor biology
- Notch inhibitors
- Notch signaling and vascular biology
- Chemotherapy and vascular disease
- Conclusions
Chapter 4: Molecular Mechanisms of Anthracycline-Induced Cardiotoxicity
- Abstract
- Historical and clinical perspectives
- Risk factors
- Molecular mechanisms of DOX mediated cardiotoxicity
- Strategies to limit anthracycline toxicities
- Conclusions
Chapter 5: Cardiotoxic Effects of Anti-VEGFR Tyrosine Kinase Inhibitors
- Abstract
- Introduction
- Angiogenesis: a two-edged sword
- Vascular endothelial growth factor and VEGFR signaling pathway
- Mechanisms of action of tyrosine kinase inhibitors targeting VEGFR
- Cardiotoxic effects by antiangiogenic drugs
- Anti-VEGFR tyrosine kinase inhibitors
- Conclusions
Chapter 6: Role of Novel Imaging Techniques in Detection of Chemotoxicity: Cardiac Magnetic Resonance and Radionuclide Imaging
- Abstract
- Introduction
- Current imaging guidelines for the detection of cardiotoxicity
- Radionuclide imaging
- Cardiac magnetic resonance imaging
- Emerging techniques
- Conclusions
Chapter 7: Cardiotoxicity Induced by Anticancer Drugs—the Role of Biomarkers
- Abstract
- Introduction
- Anticancer drugs and cardiac toxicity
- Detection of cardiac toxicity
- Prevention of cardiac toxicity
- Conclusions
Chapter 8: Myocardial Ischemia and Cancer Therapy
- Abstract
- Introduction
- Radiation induced ischemic heart disease
- Chemotherapy-induced ischemic heart disease
- Tyrosine kinase inhibitors (TKIs)
- Cancer cohort studies—ischemic heart disease
- Monitoring and treatment of ischemic cardiac toxicity
- Conclusions
Chapter 9: Radiation Therapy and Cardiovascular Risk
- Abstract
- Introduction
- Mechanism of cardiovascular injury in the setting of radiation therapy
- Cardiovascular risk by disease site
- Treatment recommendations
- Conclusions
Chapter 10: Identification of At-Risk Patients and Comorbidities That Increase Risk
- Abstract
- Cancer and cardiovascular disease
- Overlapping risk factors
- Chemotherapy and heart disease risk
- Risk factors specific to representative chemotherapies
- Risk factors specific to radiotherapy
- Biomarkers in the identification of radiation-induced cardiotoxicity
- Conclusions
Chapter 11: Late Cardiac Effects in Childhood Cancer Survivors
- Abstract
- Introduction
- Anthracycline and anthracycline-like agents
- Thoracic radiation
- Risk factors of cardiotoxicity
- Risk assessment and screening for cardiotoxicity
- Preventing and treating cardiotoxicity
- Conclusions
Chapter 12: Chemotherapy-Induced Amenorrhea and Menopause: Cardiovascular Implications
- Abstract
- Menopause
- Chemotherapy-induced menopause
- Chemotherapy and the ovaries
- The cardiovascular consequences of menopause
- Considerations of cardiovascular disease and complications due to chemotherapy-induced menopause
- Menopause treatment options
- Conclusions
Chapter 13: Cancer and Physical Activity
- Abstract
- Introduction
- Physical activity
- Physical activity during cancer treatment
- Complementary strategies
- Evaluation of physical capacity
- Cardiopulmonary reserve in cancer
- Autonomic dysfunction
- Functional capacity in cancer
- Diastolic function
- Anemia
- Benefits of exercise
- Barriers to exercise
- Conclusions
Chapter 14: Statins in Cardio-Oncology
- Abstract
- Introduction
- Background
- Statins and cancer
- Statins and mortality among cancer patients
- Statins in oncology population
- Conclusions
Chapter 15: Coordinating Cardio-Oncology Care
- Abstract
- Introduction
- Cancer and heart disease
- Cardio-oncology: an emerging multidisciplinary field
- Establishment of a cardio-oncology program
- Education of healthcare providers: training and fellowship programs
- Conclusions
Chapter 16: Assessment of Cardiovascular Risk Beyond Lipid Panel in Cardio-Oncology Patients
- Abstract
- Coronary artery disease and coronary artery calcification
- Highly sensitive C-reactive protein
- Carotid atherosclerosis and intimal medial thickness
- Peripheral atherosclerosis and ankle-brachial index
- Conclusions
Chapter 17: Hypertension and Cancer
- Abstract
- Introduction
- Epidemiology
- Diagnosis
- Pathophysiology
- Chemotherapy-induced HTN
- Steroid-induced HTN
- Erythropoietin-induced HTN
- Nonpharmacologic therapy induced HTN
- Tumor-related HTN
- Management and treatment
- Conclusions
Chapter 18: Pulmonary Hypertension and Cancer
- Abstract
- Introduction
- Definition of PH
- Classification of pulmonary hypertension
- Cancer and PAH
- Chemotherapeutic agents and PAH
- Cancer chemotherapeutic agents with potential to treat or prevent PAH
- Role of tyrosine kinase inhibitors (TKI’s) in PAH
- Conclusions
Chapter 19: The Role of Echocardiography in the Detection of Chemotherapy-Induced Cardiotoxicities
- Abstract
- Introduction
- Standard echocardiographic viewing planes
- Evaluating left ventricular ejection fraction
- 3D echo
- Calculating ejection fraction
- Diastolic dysfunction
- Right ventricular function
- Echocardiographic evaluation of pulmonary pressures
- Strain echo for cardiotoxicity
- Recommended diagnostic algorithm
- Transesophageal echocardiography
- Stress echocardiography
- Valvular dysfunction
- Pericardial disease
- Contrast use during echocardiographic examinations
- Limitations
- Conclusions
- Conflicts
Chapter 20: Principles of Cancer Rehabilitation
- Abstract
- Introduction/history of cancer rehabilitation
- Cancer-related fatigue and role of therapeutic exercise
- Cancer-related cognitive impairment
- Rehabilitation approach to pain in the patient with cancer
- Lymphedema
- Rehabilitation principles in the patient with breast cancer
- Radiation fibrosis syndrome
- Management of peripheral neuropathy and balance impairment
- Conclusions
- Acknowledgment
Chapter 21: Management of Advanced Heart Failure in a Cancer Patient
- Abstract
- Case
- Effect of advanced heart failure on cardiac risk of oncologic surgeries
Chapter 22: Heart Transplantation and Left Ventricular Assist Devices in Cancer Survivors
- Abstract
- Introduction
- Epidemiology and clinical features of therapy-induced cardiomyopathies
- Role of mechanical circulatory support in cancer survivors
- Heart transplantation in cancer survivors
- De novo malignancies after heart transplantation
- Cancer survivors as organ donors
- Conclusions
Chapter 23: Chemotherapy-Associated Arrhythmias
- Abstract
- Introduction
- Atrial fibrillation
- Anthracyclines
- Cardiac toxicity
- Electrophysiologic toxicity
- Antimetabolites
- Alkylating agents
- HER2-targeting agents and tyrosine kinase inhibitors
- Antimicrotubule agents
- Arsenic trioxide
- Thalidomide
- Histone deacetylase inhibitors
- Interleukin-2
- Amsacrine
- Conclusions
Index

Roberta A. Gottlieb

Dr. Gottlieb has been conducting NIH-funded cardiovascular research for the past 20 years. She has prior experience with The Scripps Research Institute (TSRI); SDSU where she became the first Director of the Donald P. Shiley BioScience Center, and currently as the Director of Molecular Cardiobiology at Cedars-Sinai Heart Institute.

The work in her lab has led to the discovery of the cardioprotective agents and the elucidation of their novel mechanism of action. Her expertise in cardioprotection and autophagy is recognized on a national and international level.

Dr. Gottlieb is also an entrepreneur, having started a biotechnology company called Radical Therapeutix, to develop drugs to mitigate the damage to the heart during myocardial infarction. Dr. Gottlieb received her B.S. and M.D. degrees from Johns Hopkins University.

Affiliations and expertise

Professor of Medicine, Director of Molecular Cardiobiology, Dorothy and E. Phillip Lyon Chair in Molecular Cardiology, Cedars-Sinai Heart Institute, Barbra Streisand Women’s Heart Center

Puja K Mehta

Dr. Mehta, MD, FACC is Director of the Non-invasive Vascular Function Research Laboratory in the Barbra Streisand Women's Heart Center at the Cedars-Sinai's Heart Institute. She is also Co-Director of the Cardio-Oncology Program, a clinic dedicated to the heart health of women after cancer treatment.

Dr. Mehta is board certified in internal medicine and cardiovascular diseases and board-eligible in echocardiography and nuclear cardiology. She is a member of the American Heart Association, the American Society for Preventive Cardiology and the American College of Cardiology, where she is also a fellow. In addition to academic success, she has received numerous awards including the prestigious New Jersey Foundation Humanism in Medicine Award. She has published her research in peer-reviewed journals and presented at national cardiology meetings. Dr. Mehta's research is National Institutes of Health (NIH) funded and includes the role of mental stress in heart disease, exploring the brain-heart connection and new approaches to treating chest pain in women.

Dr. Mehta’s Scival Overall Research Performance 2009-2013: 30 Publications, 245 Citations, 1.64 Field-Weighted Citation Impact, 8.2 Citations per Publication

The editors state that “We will probably enlist 2-3 more editors in order to balance the perspective, probably Melissa Hudson (oncologist) and Javid Mohslehi” and “a hypertension expert (possibly Ron Victor)” as a result of the reviewer feedback.

Affiliations and expertise

Emory Clinical Cardiovascular Research Institute