Barry Trachtenberg, M.D., a cardiologist with the Houston Methodist DeBakey Heart & Vascular Center, emphasized the necessity of heart monitoring of patients undergoing chemotherapy with anthracyclines, a group of drugs widely used to treat lymphoma, breast cancer, and leukemia.
Chemotherapy is an important and effective treatment of cancer, with significant improvements shown in both solid tumors and hematologic malignancies. However, as with most therapies, significant side effects can affect patients. Several studies and review papers have linked the use of anthracyclines with an increased risk for cardiac toxicity and development of heart failure. Moreover, the risk of developing clinically relevant anthracycline cardiotoxicity has also been shown higher in patients with certain personal characteristics, such as older age and higher body mass index (BMI).
The amount of evidence linking anthracyclines to heart problems has highlighted the importance of monitoring the heart health of patients undergoing this type of treatment. According to a study published in the American Heart Association journal, most of the heart damage resulting from anthracycline therapy occurs within the first year of treatment and it is associated with cumulative dose. As such, early diagnosis is essential, since catching the defect early on and treating it with medications can reverse heart disease risk. As it progresses, heart damage tends to be harder to reverse and eventually heart function does not return to normal. The American Heart Association recommends a standard echocardiogram and subsequent analysis during treatment of patients receiving this type of chemotherapy although specific time periods or monitoring have not been defined.
The left ventricle ejection fraction, which measures blood pumped out of the left ventricle, is regarded as an important indicator of heart function, and abnormal values can indicate the need for stopping chemotherapy with anthracyclines.
“Patients with risk factors for heart disease such as a family history, high blood pressure, diabetes, and those on chemotherapies known to have cardiac risks such as anthracyclines should be tested regularly,” Trachtenberg said in a press release. “Those on high-dose anthracyclines or on multiple agents that can damage the heart need even more careful monitoring. Fighting cancer is an incredibly tough battle for patients and the family and friends who go through it with them. We want to let people know about this possible side effect so they can take the proper steps to avoid another battle with heart disease.”