Management of COVID-19 in patients with pulmonary arterial hypertension
In this review, we discuss the evidence regarding the course and management of COVID-19 in patients with pulmonary arterial hypertension (PAH), the challenges in PAH management during the pandemic and, lastly, the long-term complications of COVID-19 in relation to pulmonary vascular disease. The inherent PAH disease characteristics, as well as age, comorbidities and the patient ’s functional status act synergistically to define prognosis of COVID-19 in patients with PAH. Management of COVID-19 should follow the general guidelines, while PAH-targeted therapies should be continued. The pandemic has caused a shift towards t...
Source: Heart Failure Clinics - August 9, 2022 Category: Cardiology Authors: Ioannis T. Farmakis, George Giannakoulas Source Type: research
Spectrum of National Institutes of Health-Funded Research in Cardio-Oncology
Advances in cancer treatments have led to nearly 17 million survivors in the US today. Cardiovascular complications attributed to cancer treatments are the leading cause of morbidity and mortality in cancer survivors. In response, NCI and NHLBI held 2 workshops and issued funding opportunities to strengthen research on cardiotoxicity. A representative portfolio of NIH grants categorizing basic, interventional, and observational projects is presented. Compared with anthracyclines, research on radiation therapy and newer treatments is underrepresented. Multidisciplinary collaborative research that considers the cardiotoxicit...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Bishow B. Adhikari, Scarlet Shi, Eileen P. Dimond, Nonniekaye Shelburne, Patrice Desvigne-Nickens, Lori M. Minasian Source Type: research
Cardioprotection of High-Risk Individuals
Targeting cardioprotective strategies to patients at the highest risk for cardiac events can help maximize therapeutic benefits. Dexrazoxane, liposomal formulations, continuous infusions, and neurohormonal antagonists may be useful for cardioprotection for anthracycline-treated patients at the highest risk for heart failure. Prevalent cardiovascular disease is a risk factor for cardiac events with many cancer therapies, including anthracyclines, anti –human-epidermal growth factor receptor-2 therapy, radiation, and BCR-Abl tyrosine kinase inhibitors, and may be a risk factor for cardiac events with other therapies. Altho...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Jenica N. Upshaw, Sharanya Mohanty, Akash Rastogi Source Type: research
Understanding Myocardial Metabolism in the Context of Cardio-Oncology
Cardiovascular events, ranging from arrhythmias to decompensated heart failure, are common during and after cancer therapy. Cardiovascular complications can be life-threatening, and from the oncologist ’s perspective, could limit the use of first-line cancer therapeutics. Moreover, an aging population increases the risk for comorbidities and medical complexity among patients who undergo cancer therapy. Many have established cardiovascular diagnoses or risk factors before starting these therapies . Therefore, it is essential to understand the molecular mechanisms that drive cardiovascular events in patients with cancer an...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Jing Liu, Zsu-Zsu Chen, Jagvi Patel, Aarti Asnani Source Type: research
Cardiac Amyloidosis
Amyloid deposits are defined by their tinctorial properties. Under the light microscope amyloid deposits are eosinophilic and amorphous when stained with hematoxylin and eosin. With Congo red staining the deposits are positive and under polarized light will exhibit green birefringence. Sixty years later electron microscopy demonstrated that all deposits were fibrillar. All amyloid deposits are protein derived. The clinical characteristics will be driven by the nature of the protein subunit. In cardiology, the 2 most common subunits accounting for well more than 90% of cardiac amyloidosis are either immunoglobulin light cha...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Morie A. Gertz Source Type: research
Arrhythmic Complications Associated with Cancer Therapies
Over the last several decades, advancements in cancer screening and treatment have significantly improved cancer mortality and overall quality of life. Unfortunately, non –cancer-related side effects, including cardiovascular toxicities can impact the continued delivery of these treatments. Arrhythmias are an increasingly recognized class of cardiotoxicity that can occur as a direct consequence of the treatment or secondary to another type of toxicity such as heart failure, myocarditis, or ischemia. Atrial arrhythmias, particularly atrial fibrillation (AF) are most commonly encountered, however, ventricular- and bradyarr...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Naga Venkata K. Pothineni, Herman Van Besien, Michael G. Fradley Source Type: research
Cardiovascular Imaging in Cardio-Oncology
Cardiovascular (CV) events are an increasingly common limitation of effective anticancer therapy. Over the last decade imaging has become essential to patients receiving contemporary cancer therapy. Herein we discuss the current state of CV imaging in cardio-oncology. We also provide a practical apparatus for the use of imaging in everyday cardiovascular care of oncology patients to improve outcomes for those at risk for cardiotoxicity, or with established cardiovascular disease. Finally, we consider future directions in the field given the wave of new anticancer therapies. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: John Alan Gambril, Aaron Chum, Akash Goyal, Patrick Ruz, Katarzyna Mikrut, Orlando Simonetti, Hardeep Dholiya, Brijesh Patel, Daniel Addison Source Type: research
T-cell Immunotherapy and Cardiovascular Disease
Chimeric antigen receptor (CAR) T-cell and bispecific T-cell engager (BiTE) therapies have revolutionized the treatment of refractory or relapsed leukemia and lymphoma. Increased use of these therapies has revealed signals of significant cardiotoxicity, including cardiomyopathy/heart failure, arrhythmia, myocardial injury, hemodynamic instability, and cardiovascular death mainly in the context of a profound inflammatory response to CAR T-cell antitumor effects known as cytokine release syndrome (CRS). Preexisting cardiovascular risk factors and disease may increase the risk of such cardiotoxicity. High index of suspicion a...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Ashley F. Stein-Merlob, Sarju Ganatra, Eric H. Yang Source Type: research
Modeling Susceptibility to Cardiotoxicity in Cancer Therapy Using Human iPSC-Derived Cardiac Cells and Systems Biology
The development of human-induced pluripotent stem cell-derived cardiac cell types has created a new paradigm in assessing drug-induced cardiotoxicity. Advances in genomics and epigenomics have also implicated several genomic loci and biological pathways that may contribute to susceptibility to cancer therapies. In this review, we first provide a brief overview of the cardiotoxicity associated with chemotherapy. We then provide a detailed summary of systems biology approaches being applied to elucidate potential molecular mechanisms involved in cardiotoxicity. Finally, we discuss combining systems biology approaches with iP...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: McKay Mullen, Wilson Lek Wen Tan, June-Wha Rhee, Joseph C. Wu Source Type: research
Therapy-Related Clonal Hematopoiesis
Clonal hematopoiesis is a precancerous state that is recognized as a new causal risk factor for cardiovascular disease. Therapy-related clonal hematopoiesis is a condition that is often found in cancer survivors. These clonal expansions are caused by mutations in DNA damage-response pathway genes that allow hematopoietic stem cells to undergo positive selection in response to the genotoxic stress. These mutant cells increasingly give rise to progeny leukocytes that display enhanced proinflammatory properties. Recent experimental studies suggest that therapy-related clonal hematopoiesis may contribute to the medium- to long...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Yoshimitsu Yura, Jesse D. Cochran, Kenneth Walsh Source Type: research
Myocardial Dysfunction in Patients with Cancer
Myocardial dysfunction in patients with cancer is a major cause of morbidity and mortality. Cancer therapy-related cardiotoxicities are an important contributor to the development of cardiomyopathy in this patient population. Furthermore, cardiac AL amyloidosis, cardiac malignancies/metastases, accelerated atherosclerosis, stress cardiomyopathy, systemic and pulmonary hypertension are also linked to the development of myocardial dysfunction. Herein, we summarize current knowledge on the mechanisms of myocardial dysfunction in the setting of cancer and cancer-related therapies. Additionally, we briefly outline key recommend...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Efstratios Koutroumpakis, Nikhil Agrawal, Nicolas L. Palaskas, Jun-ichi Abe, Cezar Iliescu, Syed Wamique Yusuf, Anita Deswal Source Type: research
Radiation-Induced Cardiac Dysfunction
This article reviews factors contributing to a thoracic cancer patient's risk for RICD, including RT dose to the heart and/or cardiac substructures, other anticancer treatments, and a patient's cardiometabolic health. It is also discussed how automated tracking of these factors within electronic medical record environments may aid radiation oncologists and other treating physicians in their ability to prevent, detect, and/or treat RICD in this expanding patient population. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Lauren N. Pedersen, Menka Khoobchandani, Randall Brenneman, Joshua D. Mitchell, Carmen Bergom Source Type: research
Training and Career Development in Cardio-Oncology Translational and Implementation Science
Cardiovascular disease is a leading cause of death in cancer survivors, after recurrence of the primary tumor or occurrence of a secondary malignancy. Consequently, the interdisciplinary field of cardio-oncology has grown rapidly in recent years to address the cardiovascular care needs of this unique population through clinical care and research initiatives. Here, the authors discuss the ideal infrastructure for training and career development in cardio-oncology translational and implementation science and emphasize the importance of the multidisciplinary cardiovascular team for both research and patient care. Cardio-oncol...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Sherry-Ann Brown, Eric H. Yang, Mary Branch, Craig Beavers, Anne Blaes, Michael G. Fradley, Richard K. Cheng Source Type: research
Translational Cardio-Oncology Research to Promote Better Outcomes for One and All
Cardio-oncology is a vital, new discipline that has experienced exponential growth over the past decade. With the ever-increasing options for effective treatment of cancer, the burden of associated cardiovascular toxicity has continued to grow, making research in cardio-oncology a priority. This research needs to include the full spectrum of basic, clinical, and population science research (Fig. 1). Basic research, “conducted without thought of practical ends,” results in “general knowledge and an understanding of nature and its laws.”1 Clinical research involves human subjects, is patient-oriented, and includes ...
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Ragavendra R. Baliga, George A. Mensah, Eduardo Bossone Tags: Preface Source Type: research
Translational Research in Cardio-Oncology
HEART FAILURE CLINICS (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - June 17, 2022 Category: Cardiology Authors: Ragavendra R. Baliga, George A. Mensah Source Type: research
