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Eur Heart J. 2018 Aug 6. doi: 10.1093/eurheartj/ehy453. [Epub ahead of print]

Cardio-Oncology Services: rationale, organization, and implementation: A report from the ESC Cardio-Oncology council.

Author information

1
Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, CHU Sart Tilman, Avenue de L'Hòpital 1, Liège, Belgium.
2
Gruppo Villa Maria Care and Research, Anthea Hospital, VIA C. ROSALBA, BARI (BA) - Puglia, Italy.
3
Department of Cardiology, lnselspital, Bern University Hospital, University of Bern.
4
Department of Cardiology, La Paz University Hospital, IdiPAZ, CiberCV, Madrid, Spain.
5
Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy.
6
Royal Brompton Hospital and Imperial College, Dovehouse Street, London, UK.
7
Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, GZ, The Netherlands.
8
UMR INSERM U-942 "BIOmarkers in CArdioNeuroVAScular diseases" Université Paris VII-Denis Diderot Assistance Publique-Hôpitaux de Paris Service de Cardiologie, Hôpital Lariboisière, 2 rue Ambroise-Paré, Paris, France.
9
University Alcala, Hospital Ramón y Cajal, Ciber CV, Madrid, Spain.
10
University of Liège Hospital, Medical Oncology, CHU Sart Tilman, Avenue de L'Hòpital 1, Liège, Belgium.
11
Department of Cardiology, Dupuytren University Hospital, Limoges, France.
12
Department of Cardiology, Leiden University Medical Center, The Netherlands.
13
Cardiologist in Practice, Corso Venezia 10, Turin, Italy.

Abstract

Aims:

Anticancer therapies have extended the lives of millions of patients with malignancies, but for some this benefit is tempered by adverse cardiovascular (CV) effects. Cardiotoxicity may occur early or late after treatment initiation or termination. The extent of this cardiotoxicity is variable, depending on the type of drug used, combination with other drugs, mediastinal radiotherapy, the presence of CV risk factors, and comorbidities. A recent position paper from the European Society of Cardiology addressed the management of CV monitoring and management of patients treated for cancer.

Methods and results:

The current document is focused on the basis of the Cardio-Oncology (C-O) Services, presenting their rationale, organization, and implementation. C-O Services address the spectrum of prevention, detection, monitoring, and treatment of cancer patients at risk of cardiotoxicity and/or with concomitant CV diseases. These services require a multidisciplinary approach, with the aims of promoting CV health and facilitating the most effective cancer therapy.

Conclusion:

The expected growing volume of patients with cancer at risk of developing/worsening CV disease, the advent of new technological opportunities to refine diagnosis, and the necessity of early recognition of cancer therapy-related toxicity mandate an integrative multidisciplinary approach and care in a specialized environment. This document from the ESC Cardio-Oncology council proposes the grounds for creating C-O Services in Europe based on expert opinion.

PMID:
30085070
DOI:
10.1093/eurheartj/ehy453
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