Cardio-Oncology

Abstract

Cardiac toxicity by chemotherapeutic agents was first described more than 50 years ago, after the introduction of Daunomycin as an antimitotic agent. The early recognition of heart failure as a side effect of anthracyclines, led the oncologists to limit its cumulative dose, and prompted them to serially monitor heart function looking for left ventricular dysfunction. Initial tools included voltage reduction in electrocardiograms and measurement of systolic ejection time assessed by “sphygmo-recording”. Nevertheless, endomyocardial biopsy and the echocardiographic evaluation of the left ventricular ejection fraction (LVEF) evolved as the methods more commonly used for the identification of anthracycline-induced cardiomyopathy. The importance of endomyocardial biopsy decreased over time due to cost, risks inherent to its invasive nature and more importantly the important advances made in noninvasive cardiac imaging. As a result, noninvasive calculation of LVEF became the most widely used tool for monitoring cardiac function during and after cancer therapy.