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ESC Heart Fail. 2017 Aug;4(3):312-318. doi: 10.1002/ehf2.12162. Epub 2017 May 2.

Protocol update and preliminary results of EACVI/HFA Cardiac Oncology Toxicity (COT) Registry of the European Society of Cardiology.

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University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.
Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy.
Cardiologie, LTSI-INSERM U 1099, CHU Rennes, Université Rennes 1, Rennes, France.
Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
Centre of Cardiological Innovation, Oslo, Norway.
Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Bucharest, Romania.
Cardio-Oncology Clinic, Heart Failure Unit, Department of Cardiology, University Hospital 'Attikon', National and Kapodistrian University of Athens, Athens, Greece.
URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection.
APHM, La Timone Hospital, Cardiology Department, Marseille, France.
Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Italy.
Department of Medical Oncology, CHU Sart Tilman Liège, University of Liège, Liège, Belgium.
ESC EORP Department, Sophia Antipolis, France.
Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Göttingen, Germany & DZHK (German Center for Cardiovascular Research).
Division of Cardiology and Metabolism - Heart Failure, Cachexia & Sarcopenia; Department of Internal Medicine & Cardiology; and Berlin-Brandenburg Center for Regenerative Therapies (BCRT), at Charité University Medicine, Berlin, Germany.



European Association of Cardiovascular Imaging/Heart Failure Association Cardiac Oncology Toxicity Registry was launched in October 2014 as a European Society of Cardiology multicentre registry of breast cancer patients referred to imaging laboratories for routine surveillance, suspected, or confirmed anticancer drug-related cardiotoxicity (ADRC). After a pilot phase (1 year recruitment and 1 year follow-up), some changes have been made to the protocol (version 1.0) and electronic case report form.


Main changes of the version 2.0 concerned exclusion criteria, registry duration, and clarification of the population characteristics. Breast cancer radiotherapy has been removed as an exclusion criterion, which involves now only history of a pre-chemotherapy left ventricular dysfunction. The period for long-term registry recruitment has been reduced (December 2017), but the target study population was extended to 3000 patients. The characteristics of the population are now better defined: patients seen in an imaging lab, which will include patients undergoing chemotherapy with associated targeted therapy or no targeted therapy, at increased risk of ADRC. In total, 1294 breast cancer patients have been enrolled, and 783 case report forms locked from October 2014 to November 2016. Of these, 481 (61.4%) were seen at first evaluation and 302 (38.6%) while on oncologic treatment with anticancer drugs. Fifty-two patients (17.2%) were not in targeted therapies, 191 (63.3%) were ongoing targeted therapy, and 59 (19.5%) had completed it. Twenty-three (2.9%) patients had a suspected diagnosis and 35 (4.5%) a confirmed diagnosis of ADRC. Arterial hypertension was the most prevalent cardiovascular risk factor (29.2%) followed by diabetes (6.1%). Previous history of heart failure accounted for 0.5%, whereas previous cardiac disease was identified in 6.3% of population.


The changes of the original protocol of the COT Registry and first update allow a first glance to the panorama of cardiovascular characteristics of breast cancer patients enrolled.


Anticancer drug-related cardiotoxicity; Arterial hypertension; Cardiac imaging; Heart failure; Targeted therapy

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