ABC Heart Fail Cardiomyop 2022; 2(4): 343-353
Heart Failure with Preserved Ejection Fraction and Cancer
Antonio José Lagoeiro Jorge, Humberto Villacorta, Luiz Claudio Danzmann
, Evandro Tinoco Mesquita
Abstract
Heart failure with preserved ejection fraction (HFpEF) is associated with high morbidity and mortality. After hospitalization for heart failure, the 5-year survival of HFpEF is 35%, which is worse than many forms of cancer. HFpEF and cancer share common risk factors. The use of chemotherapy medications such as anthracyclines is associated with increased aortic stiffness and diastolic dysfunction, suggesting that anthracycline therapy may increase the risk of HFpEF, given that worsening of diastolic function, which can be associated with the occurrence of HFpEF, is an early sign of cardiotoxicity. Radiotherapy, widely used in the treatment of breast cancer, leads to an increased risk of developing heart disease since radiation induces coronary microvascular endothelial damage and inflammation, leading to microvascular rarefaction, myocardial inflammation, oxidative stress, and fibrosis, which favor the development of HFpEF. Early diagnosis of cardiotoxicity is an important issue in the care of patients with cancer, and biomarkers have been extensively studied in predicting systolic dysfunction and heart failure with reduced ejection fraction, as well as in the development of HFpEF. HFpEF and cancer have an elevated prevalence, and they share age group, risk factors, and the pathophysiological phenomenon, in which inflammation plays a preponderant role. Biomarkers, especially natriuretic peptides, and ultrasound imaging are fundamental tools in the diagnostic detection and follow-up of these patients.
1,047
