Title:Management of Chemotherapy Induced Cardiomyopathy
VOLUME: 7 ISSUE: 4
Author(s):Abdulfattah Saidi and Rami Alharethi
Affiliation:Division of Cardiology, University of Utah Health Sciences Center, Salt Lake City, Utah 84132 USA.
Keywords:Cardiomyopathy, Chemotherapy, Management.
Abstract:Chemotherapy related cardiac dysfunction (CRCD) is a serious complication of anticancer therapy. CRCD can
be classified into two types. Type I CRCD is exemplified by anthracyline- induced cardiac dysfunction and type II CRCD
is exemplified by trastuzumab- induced cardiac dysfunction. The mechanism of cardiac toxicity in both types is not well
defined. Certain risk factors may play a role in developing the cardiac injury, most importantly, the cumulative dose when
dealing with anthracycline induced cardiotoxicity. Establishing an early diagnosis and initiating early treatment may be an
important step in preventing irreversible cardiac injury especially in type I CRCD. Currently there are no guidelines developed
specifically for the treatment of chemotherapy induced cardiomyopathy (CIC), however a few small studies support
the use of neurohormonal antagonists in the treatment and prevention of CIC. Large multi- centers trials are needed to
establish guidelines for CIC. Until then, we advocate following the American College of Cardiology/ American Heart Association
(ACC/AHA) and Heart Failure Society of America (HFSA) guidelines. Additionally, a close collaboration between
the patient’s cardiologist and oncologist is strongly recommended in order to establish a long term plan for the patient.
