Cardio-Oncology in Austria

In Austria, the number of newly diagnosed cancers is round 40,000, with a yearly mortality of 20,000 patients with a main diagnosis of cancer. The Austrian cardiologists usually examine patients with diagnosed cancer in an outpatient setting as needed during therapies, e.g. for echocardiography, or at the university clinics if further treatment is necessary.

Several years ago, the Cardio-Oncology group of the Medical University of Vienna (leader Prof. J. Bergler-Klein) established two prospective clinical registries, to enable to treat and continuously follow oncologic patients with cardiac abnormalities, on a regular outpatient clinical basis. One of the registers includes patients who suffer from primary cardiac diseases, such as ischemic heart disease or valve diseases and receive anticancer treatment, or patients with cardiotoxicity as a consequence of the oncologic therapy. The second registry includes adult patients who have survived a childhood-cancer, and need cardiovascular care and follow-up screening. Measuring several biomarkers in more than 500 patients with heart failure, the heart failure group of the University Clinic in Vienna summarized the findings, that cancer itself may induce elevation of cardiac biomarkers, such as hs Troponine T or NT-proBNP, even before the start of anticancer treatment. The elevations of these biomarkers were strongly correlated with all-cause death, suggesting a direct effect of malignancies on heart structure and function (1).

Performing translational animal experiments, our experimental group of the Department of Cardiology has revealed, that in contrast with the general view of clinical cardiotoxicity, elevated cardiac markers were measured in all study animals (2), even with few cardiac symptoms, which underlines and urges the increasing evidence, that all patients with anticancer therapies should be treated early and preventively, possibly before the first signs of cardiotoxicity are developed (3).

Due to the increasing cardio-oncology activities at congresses in Austria, awareness is rising in the Austrian cardiology and oncology communities. The University cardiology clinics e.g. in Graz are increasingly performing outstanding scientific projects (4-6). The Austrian Society of Cardiology and the Austrian working groups for heart failure or echocardiography are undertaking efforts to further transport the importance of cardiac care in cancer patients along with the current and evolving recommendations (7-9).

Authors

Jutta Bergler-Klein, MD, Prof. of Med., FESC, FHFA

Mariann Gyöngyösi, MD, Prof. of Med., FESC

Dept. of Cardiology, Medical Univ. of Vienna, Austria

Waehringer Guertel 18-20, 1090 Vienna, Austria