What is the greatest risk for anthracycline-induced cardiotoxicity?

As noted above, the greatest risk factor for anthracycline-induced cardiotoxicity is the cumulative dose.

What is anthracycline-induced cardiomyopathy?

Anthracycline-induced (doxorubicin, daunorubicin, epirubicin, idarubicin) cardiomyopathy is a disease spectrum ranging from development of heart failure (HF) with symptoms and clinical signs to asymptomatic decline in left ventricular ejection fraction (LVEF). Clinical HF may ensue in up to 5% of high-risk patients.

How long after completion of anthracycline therapy can late onset toxicity occur?

[10,11] Late-onset cardiotoxicity occurs more than 1 year after completion of anthracycline treatment. The late toxicity is a major concern in clinical scenarios where anthracyclines are used as part of a curative or adjuvant regimen-for example, in patients with breast cancer.

Does anthracycline cause cardiomyopathy?

Anthracycline-induced cardiac dysfunction (ACD) is a notorious side effect of anticancer treatment. It has been described as a phenomenon of a continuous progressive decline of cardiac function, eventually leading to dilated cardiomyopathy (DCM).

Is cardiotoxicity reversible?

With the exception of anthracyclines, cardiotoxicity from most targeting agents is reversible. Concomitant use of cardiotoxic drugs should be avoided, and early detection of asymptomatic cardiac dysfunction is important.

How do you prevent doxorubicin toxicity?

Conclusions: Dexrazoxane is hydrolyzed to its active form intracellularly and binds iron to prevent the formation of superhydroxide radicals, thus preventing mitochondrial destruction. The effect of dexrazoxane on the prevention of doxorubicin-induced cardiotoxicity is impressive in both animal and human studies.

Which antitumor antibiotic drug is toxic to the heart?

VBI was found to be only toxic on the heart but not on the bone marrow, whereas DAU, VBII and CAR were predominantly toxic on the bone marrow. Only ADR showed strong cardiac toxicity as well as distinct myelosuppression.

Can cyclophosphamide cause heart problems?

The incidence of acute heart failure is anywhere between 7% and 33% of patients receiving a total dose of more than 150 mg/kg cyclophosphamide. Fatal cyclophosphamide cardiomyopathy varies between 2% and 17% depending on different dosing regimens and patient populations.

What does cardiotoxic mean?

Cancer drugs and treatments can cause direct damage to the heart. This is known as cardiotoxicity.

Why does herceptin cause cardiotoxicity?

Cardiotoxicity of trastuzumab is considered to be the result of attenuated HER2-mediated signaling in the heart, culminating in decreased functionality of cardiac myocytes. HER2 appears to function as a compensatory mechanism acting against cardiac stress, such as anthracycline-induced cardiotoxicity.

Is trastuzumab reversible?

It is unpredictable, it does not appear to be dose-dependent, and it is reversible. About 80% of patients receiving trastuzumab as adjuvant treatment will maintain a normal left ventricular ejection fraction (lvef), and therefore questions naturally arise about how otherwise to monitor for potential cardiotoxicity.

What is doxorubicin toxicity?

While an effective anti-tumor agent, doxorubicin causes cumulative and dose-dependent cardiotoxicity, ranging from occult changes in myocardial structure and function to severe cardiomyopathy and congestive heart failure that may result in cardiac transplantation or death1 , 2 , 3 , 4 , 5 , 6.

What does doxorubicin do to the heart?

Doxorubicin causes both early and late heart damage (also called cardiotoxicity). The early damage occurs immediately after drug administration or within 1 to 2 days. There are minor effects that are picked up on the electrocardiogram (EKG) and in most cases resolve without causing any major problems.

Why does doxorubicin affect the heart?

Doxorubicin appears to induce toxic damage to the mitochondria of cardiomyocytes. Several mitochondrial enzymes such as NADH dehydrogenase, cytochrome P-450 reductase and xanthine oxidase are involved in generating oxygen free radicals (reactive oxygen species) [3,23,24,25].

Is anthracycline induced heart failure reversible?

The two chronic forms are considered irreversible, with a poor prognosis and a limited to heart failure therapy.

What is the most toxic chemotherapy drug?

Doxorubicin, an old chemotherapy drug that carries this unusual moniker because of its distinctive hue and fearsome toxicity, remains a key treatment for many cancer patients.

What are the symptoms of cardiac toxicity?

Symptoms of cardiac toxicity may include:

Is heart damage from chemotherapy reversible?

Cardiotoxicity can be defined as a direct effect of chemotherapy resulting in cardiac dysfunction which may lead to reversible/irreversible heart failure.

How do you manage cardiotoxicity?

Some of the common drugs that are used to treat cardiotoxicity may include:

  1. Dexrazoxane hydrochloride – May be used to prevent or reduce the occurrence and severity of heart damage (cardiomyopathy) caused by doxorubicin (Adriamycin®).
  2. ACE inhibitors – These drugs work by opening, or dilating, your arteries.

Is doxorubicin cardiotoxicity reversible?

Because severe doxorubicin cardiotoxicity is reversible in some patients, aggressive supportive therapy is warranted.

How is cardiotoxicity treated?

The most common medications used for cardiotoxicity treatment include: Beta-blockers, which slow down a patient’s heart rate, lower a patient’s blood pressure and strengthen the heart muscle can reduce palpitations and arrhythmias, hypertension and heart failure.

Which is the most serious side effect of doxorubicin?

Get medical help right away if you have any very serious side effects, including: chest pain. Within days to weeks after doxorubicin treatment, a serious skin reaction that looks likes a severe sunburn (radiation recall) may develop on any area of skin that has been previously treated with radiation.

What chemo drugs can affect the heart?

Chemotherapy drugs that can cause heart damage include:

When do Adriamycin side effects start?

Nausea or vomiting (You will be pretreated for this side effect)Later Side Effects: (within two weeks after treatment begins)

Can cyclophosphamide cause lung damage?

Cyclophosphamide is a chemotherapeutic agent with the potential to cause pulmonary toxicity, most commonly in the form of diffuse alveolar damage.

Is cyclophosphamide cardiotoxicity reversible?

Acute cardiotoxicity occurs during or shortly after the infusion with an incidence of <1%, and involves arrhythmias, heart failure, pericarditis-myocarditis syndrome, and nonspecific ST-T changes, which are usually reversible.

Does tamoxifen cause cardiotoxicity?

Although physicians have known for 30 years that anthracyclines cause acute and chronic cardiotoxicity, the cardiotoxic effects of radiation therapy, hormonal therapy (including tamoxifen and the aromatase inhibitors), and chemotherapy with taxanes and trastuzumab treatment have emerged more recently.

What are 4 stages of heart failure?

There are four stages of heart failure – stage A, B, C and D – which range from high risk of developing heart failure to advanced heart failure.

Can Taxol cause heart damage?

Cardiac toxicity was first noted in patients receiving Taxol during continuous cardiac monitoring, which was performed because of the high incidence of serious hypersensitivity reactions noted early in phase I trials.

Is caffeine related to heart damage?

While there is often concern about the links between caffeine and heart health, a moderate amount of tea or coffee (four or five cups a day) should be fine for most people. Research shows that this level of caffeine intake shouldn’t be detrimental to your heart health, affect your cholesterol levels or heart rhythm.