Mr Helmut Drexler
There are millions of new cancers every year and 60% of patients receive chemotherapy and therefore are at risk of chemotherapy-induced cardiotoxicity. In fact, it appears that chemotherapy in childhood increases cardiac risk 8 fold. Chemotherapy-induced cardiomyopathy has a bad prognosis. It is crucial to identify these patients early. If treatment with ACE inhibitors and ß-blockers are instituted later than 6 months after LV dysfunction and heart failure occurs, there is no beneficial effect any more.
Ongoing damage can be identifed by troponin T or I measurement, in fact prolonged elevated levels of troponin predicted LV dysfunction.
Cachexia is a major complicating condition and impairs outcome both in patients with cancer and heart failure. It appears that development of cachexia can be attenuated with ACE-inhibitors and ß-blockers. Spironolactone may even be able to increase body weight in this setting.
Early identification of cardiotoxicity after chemotherapy is crucial and early initiation of treatment with ACE inhibitors and ß-blockers is quite effective.
Heart failure and cancer
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