Science and Technology
  • Dr. Piter Martinez Benitez
  • 06/25/2021
  • 3751 lượt đọc

CARDIO-ONCOLOGY - A NEW SUBSPECIALTY: Cardiovascular Toxicity Secondary To Onco-Hematologic Treatments.

Most patients who receive onco-hematologic treatment have a potential risk of cardiotoxicity. Cancer patients can present a variety of cardiovascular problems, the most frequent: ischemia, arrhythmias, valvular heart disease, pericardial disease, heart failure, among others.

As in cardiology, teamwork is required with members of different subspecialties of cardiology; the way forward will be to adopt a multidisciplinary approach to produce optimal individual care. Close collaboration between cardiology and oncology specialists in a cardio-oncology setting can make this happen (1)(2).


Reason to work together: Cancer and heart disease are the leading causes of morbidity and mortality in the industrialized world; mortality rates from cancer have declined over the past 30 years because of improvements in the treatment; cardiovascular disease is the second cause of long-term morbidity and mortality among cancer survivors (3)(4)(5)(6). 


The cardio-oncology goals are facilitating cancer treatment and protecting the heart: reduce the risk produced by the onco-hematology treatment; control of the cardiovascular risk factors and comorbidities; early detection of subclinical left ventricular dysfunction among others (3)(7).


For instance; early detect cardiac dysfunction is a challenge in asymptomatic patients, and it will impact the prognosis of our patients. Perform a specialized cardiology consultation lets us evaluate electrocardiogram, echocardiogram, and biomarker of myocardial damage (8)(9). 


The cardio-oncology unit was created in our hospital to improve the quality of care of those patients. In a short period, it has been possible to raise the level of satisfaction of the patients and the family, as well as achieve a close team collaboration on the part of the cardiology and oncology departments. We have been included in the protocol Strain Imaging Echocardiography; cardioprotection using Strain Imagine guided management of potentially cardiotoxic cancer therapy has been showing superiority to recognize early cardiac dysfunction in patients undergoing cardiotoxic therapy. 


The results of our experience are as follows:


  1. Promote effective communication and decision-making channels among professionals involved in cancer treatment.
  2. Stratify the CV risk of the Onco-hematological patient.
  3. Develop protocols for prevention, diagnosis, and early treatment as well as follow-up of cardiovascular complications.
  4. Facilitate oncological treatment and avoid interruptions in the administration of antitumor treatment.
  5. Register and evaluate the results in health and quality of care and coordinate research protocols.
  6. Promote training programs for professionals involved in the care of patients with cancer and CV disease.

Our purpose is to provide information to our patients on this subject, as well as to motivate cardiologists and oncologists to delve into the necessary and essential path of teamwork to provide quality medical care.  


 


Dr. Piter Martinez Benitez. Dr.Duong Thanh Binh. (Cardiologist)


Dr. Jesus de los Santos Reno Cespedes. Dr. Bui Vi Nhan. Dr. Nguyen Le Thi Quyen. (Oncologist)


 



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