Emerging Challenges Of Cardiovascular And Metabolic Dysfunctions In Cardio Oncology From Bench To Bedside

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Cardio-oncology is a medical subspecialty concerned with the diagnosis and treatment of cardiovascular disease (CVD) and organ failure mediated by micro- to macro-circulation defects in cancer patients and survivors. The risk of CVD in cancer survivors is eight times higher than the general population, and the relative risk of coronary artery disease and heart failure (HF) is 10 times and 15 times higher, respectively, compared to their siblings without cancer. It is important to note that cancer treatments including chemotherapy and radiation can lead to both short- (< 1 year) and long-term (> 5 years) cardiovascular complications. Previously, Dr. Edward T.H. Yeh initiated the MD Anderson Practice (MAP) project, and published 16 MAPs to provide the current best practice we considered at UT MD Anderson. As shown in these MAPs, one of the key issues of cardio-oncology practice and science is how we can allow cancer patients to receive maximum and uninterrupted treatments for cancer while protecting them from cancer therapy-mediated cardiovascular complications. Therefore, it is crucial to understand not only pathophysiology of CVD, but also mechanistic insights of how each cancer treatment can control cancer growth and metastasis. Without having the profound knowledge in the pathophysiological, clinical and epidemiologic aspects of cardiovascular complications of existing cancer therapy, it is impossible to establish the strong evidence-based strategies and approaches for both short- and long-term cardiovascular complications after cancer treatment. In addition, we believe that cardio-oncology science should not be restricted to deal with the side effects of each specific cancer drug, because many common cardiovascular phenotypes among the different cancer treatments are also observed. This Research Topic provides a comprehensive overview from both of the current research and practice, and a platform for obtaining the logical and up-to-date treatment and prevention of CVD in cancer patients and survivors.

This new volume updates the reader on selected areas of targeted therapy in breast cancer, with special emphasis on chemoprevention strategies, drug resistance, biomarkers, combination chemotherapy, angiogenesis inhibition and pharmacogenomics in the context of clinical efficacy. This selected review of targeted therapies will guide the reader on effective treatment as part of an integrated programme of patient management.

Heart failure is a serious condition caused by the heart failing to pump enough blood around the body at the right pressure. It usually occurs because the heart muscle has become too weak or stiff to work properly, most commonly caused by heart attack, high blood pressure or cardiomyopathy (heart disease). This textbook is a comprehensive guide to the latest advances in the diagnosis and management of heart failure. Comprising nearly 1000 pages, the book features 15 sections, beginning with discussion on clinical issues of heart failure, followed by imaging techniques. Each of the following sections covers a different disorder or disease that subsequently may lead to heart failure. Topics include coronary artery disease, stroke, arrhythmia, hypertension, nutritional aspects, cardio-oncology, and much more. The book concludes with rehabilitation, legal aspects, and future directions. Authored by internationally recognised experts in the field, the text is further enhanced by clinical photographs, diagrams and tables. Key points Comprehensive guide to latest advances in diagnosis and management of heart failure Extensive text comprising nearly 1000 pages covering numerous associated disorders and diseases Internationally recognised editor and author team Highly illustrated with clinical photographs, diagrams and tables

This book analyzes in detail all aspects related to endocrine and metabolic late effects observed in patients treated for cancer, both in childhood and adulthood. The chapters focusing on the possible pathogenic mechanisms of late effects (i.e., premature aging and chronic inflammation) and on bone health in cancer survivors are particularly interesting and innovative. The volume also deals with hypothalamic-pituitary, thyroid and gonadal disorders, including infertility and how to prevent it. Finally, the relationship between metabolic alterations and cardiovascular diseases in cancer survivors is addressed. Thanks to advances in cancer treatment and supportive care, the five-year survival rate of cancer patients is constantly increasing. However, this undisputable success of medicine has a flip side: the late adverse effects of anticancer therapies. Pediatric oncologists were the first to cope with late complications of treatments, but today also adult oncologists and onco-hematologists recognize the relevance of this issue. Even though late effects observed in cancer survivors can affect any organ or system, endocrine and metabolic dysfunctions are the most frequently reported. Endocrine complications rarely influence life expectancy of cancer survivors, but they can significantly impact morbidity and quality of life. Among endocrine adverse effects, severe hypothalamic damage may be considered the most harmful in survivors, leading to morbid obesity, propensity to metabolic syndrome and cardiovascular disease. This book aims to disseminate the knowledge about endocrine and metabolic adverse effects of cancer therapies and about survivorship care. Since the number of cancer survivors is steadily growing in the general population, this publication is intended not only for endocrinologists but also for oncologists, onco-hematologists, internists, pediatric specialists in those areas and general practitioners, with the aim to better counsel and monitor cancer survivors.

Strain imaging (also known as speckle-tracking echocardiography or STE) is a rapidly growing, affordable, and versatile cardiac imaging technology of great interest to clinicians in both inpatient and outpatient settings. ASE's Comprehensive Strain Imaging is the first reference designed to help you master a wide range of strain imaging/STE applications, including screening, diagnosis, treatment, and follow up. Written and edited by a team of international experts from the American Society of Echocardiography (ASE), this new resource provides the information you need to optimize imaging acquisition and analysis using this important new echocardiography method. Covers step-by-step techniques on how to use strain imaging with expert tips on nuances, pitfalls, and clinical decision making. Discusses the growing range of strain imaging applications for assessing diastolic function, atrial function, heart failure, arterial disease, valve disease, hypertrophy, and other common cardiovascular conditions. Provides up-to-date information on screening and follow up of patients who receive cardio-toxic oncologic agents during cancer treatment and evaluation of patients with cardiomyopathy, heart failure, arterial disease, valve disease, implantable pacemakers, pericardial disease, hypertrophy, ischemic disease, and chest radiation. Includes more than 150 images using the latest strain imaging technology, as well as videos that depict evaluation and monitoring of patients with cardiomyopathies. Addresses future applications, including elastography.

Cardiac biomarkers such as troponins and natiuretic peptides have made a great impact on clinical decision making as well as improving our understanding of molecular mechanisms of different disease conditions. However, the biomarkers that are currently in use do not reflect all the multiple disease pathways that are involved in a broad spectrum of cardiac disease conditions ranging from acute coronary syndrome, to heart failure (and heart failure with preserved ejection fraction, HFpEF), to pulmonary hypertension or arrhythmias. In this Special Issue, we will provide an overview of the current developments in the field of biomarker research, beginning with research on molecular pathways and cellular communication (e.g., microRNA) up to the clinical use of biomarkers.

Stroke is a major cause of death and the major cause of adult neurological disability in most of the world. Despite its importance on a population basis, research into the genetics of stroke has lagged behind that of many other disorders. However, the situation is now changing. Anincreasing number of single gene disorders causing stroke are being described, and there is growing evidence that polygenic factors are important in the risk of apparently "sporadic" stroke.Stroke Genetics provides an up-to-date review of the area, suitable for clinicians treating stroke patients, and both clinical and non-clinical researchers in the field of cerebrovascular disease. The full range of monogenic stroke disorders causing cerebrovascular disease, including ischaemicstroke, intracerebral haemorrhage, aneurysms and arteriovenous malformations, are covered. For each, clinical features, diagnosis, and genetics are described. Increasing evidence suggest that genetic factors are also important for the much more common multifactorial stroke; this evidence isreviewed along with the results of genetic studies in this area. Optimal and novel strategies for investigating multifactorial stroke, including the use of intermediate phenotypes such as intima-media thickness and MRI detected small vessel disease are reviewed. The book concludes by describing apractical approach to investigating patients with stroke for underlying genetic disorders. Also included is a list of useful websites.