Chemotherapy induced cardiotoxicity

Life expectancy of cancer patients has considerably increased in the last 20 years, but adverse events associated to chemotherapy have also been more frequent. Chronic cardiac toxicity of antineoplastic agents can compromise survival and quality of life, independent of the oncological prognosis. A wide range of chemotherapy drugs have been associated to cardiovascular adverse events, and until nowadays there are no well established protocols for early detection of cardiac toxicity. Some methods help in identifying initial cardiomyopathy, such as the echocardiogram, the biochemical markers troponin I and natriuretic peptide, and endomiocardial biopsy. Chemotherapy induced cardiotoxicity seems to be irreversible, and once myocardial dysfunction is established, the treatment is not dependent of the causative drug. Recent studies suggest a role for specific agents such as dexrazoxan, eritropoietin, thrombopoietin and angiotensin converting enzyme inhibitors in preventing chemotherapy induced cardiotoxicity.