Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies
ÖKG Heart Failure Working Group · 2022 · Austria
Source and licence
- Authors
- Jutta Bergler-Klein, Peter P Rainer, Markus Wallner et al.
- Title
- Cardio-oncology in Austria: cardiotoxicity and surveillance of anti-cancer therapies
- Journal
- Wiener Klinische Wochenschrift, 2022
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC9065248
Licence statement of the original publication
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Open the original publication →Full text on Europe PMC
Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
Survival in cancer is continuously improving due to evolving oncological treatment. Therefore, cardiovascular short-term and long-term side effects gain crucial importance for overall outcome. Cardiotoxicity not only presents as heart failure, but also as treatment-resistant hypertension, acute coronary ischemia with plaque rupture or vasospasm, thromboembolism, arrhythmia, pulmonary hypertension, diastolic dysfunction, acute myocarditis and others. Recent recommendations have proposed baseline cardiac risk assessment and surveillance strategies. Major challenges are the availability of monitoring and imaging resources, including echocardiography with speckle tracking longitudinal strain (GLS), serum biomarkers such as natriuretic peptides (NT-proBNP) and highly sensitive cardiac troponins. This Austrian consensus encompasses cardiotoxicity occurrence in frequent antiproliferative cancer drugs, radiotherapy, immune checkpoint inhibitors and cardiac follow-up considerations in cancer survivors in the context of the Austrian healthcare setting. It is important to optimize cardiovascular risk factors and pre-existing cardiac diseases without delaying oncological treatment. If left ventricular ejection fraction (LVEF) deteriorates during cancer treatment (from >10% to <50%), or myocardial strain decreases (>15% change in GLS), early initiation of cardioprotective therapies (angiotensin-converting enzyme inhibitors, angiotensin or beta receptor blockers) is recommended, and LVEF should be reassessed before discontinuation. Lower LVEF cut-offs were recently shown to be feasible in breast cancer patients to enable optimal anticancer treatment. Interdisciplinary cardio-oncology cooperation is pivotal for optimal management of cancer patients.
Contents of the original publication
The section headings of the original.
- Introduction
- Definition of cardiotoxicity
- Specific potentially cardiotoxic anti-cancer agents
- Anthracyclines
- Recommendations for anthracycline treatment
- HER2 targeted therapy
- Recommendations for HER2-targeted therapies
- Hormone modulating endocrine therapies
- Recommendations for hormone modulating therapy
- VEGF and tyrosine kinase inhibitors
- Basic science—mechanistic insights
- Recommendations for TKIs
- Immune checkpoint inhibitors
- Recommendations for surveillance and treatment of ICI myocarditis
- New immune therapies, chimeric antigen receptor (CAR) T-cell therapies
- Alkylating, antimicrotubule agents, fluoropyrimidines
- Recommendations during cisplatin or fluoropyrimidine treatment
- Proteasome inhibitors (PI) and immunomodulatory agents (IMID)
- Recommendations for PI and IMID
- Cyclin-dependent kinase 4/6 inhibitors
- Recommendations for CDK 4/6 inhibitors
- Therapy of cardiotoxicity and general recommendations in oncological agents
- Radiation therapy: early and late cardiotoxicity
- Recommendations after radiation therapy
- Survivors of childhood cancer
- Recommendations in survivors of childhood cancer
- Special aspects
- Long-term cardiovascular monitoring
- Exercise therapy for oncological patients
- Conclusions and gaps of evidence
- Outlook in Austria
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