Chemotherapy and Radiation-Associated Cardiac Autonomic Dysfunction

AbstractPurpose of ReviewCardiovascular autonomic dysfunction (AD) among cancer survivors is increasingly being recognized. However, the mechanisms and incidence are poorly understood. In this review, the clinical features, diagnostic modalities, proposed mechanisms, and currently available treatments of cardiovascular AD in cancer survivors are described.Recent FindingsMuch of our current understanding of cardiovascular AD is based on disease states such as diabetes, multisystem atrophy, and Parkinson ’s disease. Several non-invasive tests, measurements, and scoring systems have been developed as surrogates for autonomic function, with some even demonstrating associations with all-cause mortality. The mechanism of cardiovascular AD specifically in the cancer population, however, has not been di rectly studied. The etiology of cardiovascular AD in cancer survivors is likely multifactorial, and proposed mechanisms include direct nerve damage by chemoradiation, the pro-inflammatory state associated with malignancy, and paraneoplastic syndromes. It may also be that cardiovascular AD is an earl y marker of global cardiomyopathy rather than its own condition. Current pharmacologic options for cardiovascular AD are extrapolated from how it has been treated in other disease processes, and these agents have not been studied in the cancer population or compared head-to-head.SummaryCardiovascular AD in cancer survivors can cause significant debilitation and may be associated with all...
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research