Cardio-oncology

Putting the heart
into long-term cancer care Using ultrasound to manage and diagnose cardiotoxicity

1 in 10 infographic
1 in 10 cancer patient die due to cardiovascular problems1
Mortality risk inforgraphic
Cancer patients have on average a 2-6 times higher mortality risk due to cardiovascular disease than the
general population*2
1 in 10 cancer patient die due to cardiovascular problems1
Cancer patients have on
average a
2-6 times
higher mortality
risk 
due to
cardiovascular
disease than the
general population*2
The statistics speak for themselves: Cardiovascular issues, such as chemotherapy-induced cardiomyopathy and cardiac-dysfunction, can cause problems for cancer patients – even years after therapy. There's significant potential to support outcomes by identifying indicators as soon as possible. This calls for an efficient collaboration between cardiologists and oncologists.

Discover how you can integrate Philips technology into new or existing cardiac ultrasound systems to diagnose and manage cardiotoxicity.

What is cardiotoxicity?


Cardiotoxicity explores how certain cancer therapies have been shown to cause an increased risk of cardiac cell damage and symptomatic heart failure. Perhaps the most common cardiotoxic effect is left ventricular (LV) dysfunction, mainly associated with the application of anthracyclines and trastuzumab.1

 

Earlier diagnosis of damage enhances the opportunities to accommodate cardioprotective treatment while continuing the cancer treatment.

image video thumbnail image

What is cardiotoxicity?


Cardiotoxicity explores how certain cancer therapies have been shown to cause an increased risk of cardiac cell damage and symptomatic heart failure. Perhaps the most common cardiotoxic effect is left ventricular (LV) dysfunction, mainly associated with the application of anthracyclines and trastuzumab.1

 

Earlier diagnosis of damage enhances the opportunities to accommodate cardioprotective treatment while continuing the cancer treatment.

Ecocardiography screen

What can be done to manage cardiotoxicity?

Managing the risk of cardiotoxicity takes cooperation between cardiologists and oncologists; ideally starting with a baseline cardiac assessment of patients scheduled to receive potentially cardiotoxic agents.4

 

However, the simple and widely available assessment of left-ventricular ejection fraction (LVEF) by 2D echochardiography often fails to detect the small changes in LV contractility. More accurate measurements are available from 3DEF. But it is global longitudinal strain (GLS) that completes either analysis, as the optimal parameter of deformation for the early detection of subclinical LV dysfunction.4

ASE

ASE webinar series


Echocardiographic assessment in the diagnosis and management of cardiotoxic effects of cancer therapy: A case-based presentation for the practitioners.
Dr Teresa López Fernández
Dynamic HeartModelA.I. and AutoStrain provide valuable insights to support cardiovascular monitoring and cardiotoxicity prevention, in close collaboration with oncologists and hematologists.

Dr Teresa López Fernández

Cardiac Imaging and Cardio-Oncology Unit Leader, La Paz University Hospital, Madrid, Spain

Collaborative care – across disciplines, across time

Excellent patient care in everyday practice
Excellent patient care in everyday practice
One-button, automated measurements - of GLS, using Philips AutoStrain or 3DEF using Philips Dynamic HeartModelA.I.** - mean both experienced and new operators can achieve the same robust and reproducible results. This not only makes it efficient in routine clinical use, it also enhances your flexibility when planning exams.
Get accurate and reproducible values
Get accurate and reproducible values for follow-up examinations
For diagnostic confidence when managing cancer patients, the reproducibility and accuracy of measurements is key. The reproducibility of GLS and accuracy of 3DEF measurements have been found to be superior to conventional echocardiographic measurements (like 2DEF) in many cases.5
Personalize care with rich clinical insigh
Personalize care with rich clinical insight
Having AutoStrain – or Dynamic HeartModelA.I. – on your Philips cardiac ultrasound system, simplifies how you store and administer your results for easy access, whether for reporting or discussion. Oncologists and tumor boards can also incorporate these results into their decision making process for adjusting treatments.
Keep patients at the center of your care
Keep patients at the center of your care
Addressing cardiotoxicity risks for cancer patients is essential in averting potential heart damage. A concerted, multidisciplinary approach - involving oncologists and cardiologists - helps you provide holistic patient care.
*

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Automated GLS measurement for routine clinical use
Automated GLS measurement for routine clinical use
On-cart or for post-processing, AutoStrain offffers a simple, fast GLS solution, driven by Auto View Recognition and Auto Contour Placement. Trained on more than 6000 images to ensure robustness, AutoStrain LV provides one-button-push, reproducible left ventricle strain measurement for everyday clinical use.
  • Watch how quickly you can obtain global longitudinal strain measurements in AutoSrain.
  • Dive into the advanced automation technologies behind AutoSrain to increase diagnostic confidence and accelerate workflows.
  • Discover how AutoSrain can help routinely detect LV dysfunction in clinical practice.
Cardiology quantification designed to increase confidence

Cardiology quantification designed to increase confidence

Philips Dynamic HeartModelA.I. is a 3D tool that provides robust, reproducible ejection fraction (EF) in seconds as part of a routine workflow.

  • Watch how easy it is to make 3D measurements with Dynamic HeartModelA.I.
  • Explore how 3D ultrasound measurements can enhance your cardiac function assessments
  • Keen to get more out of your Dynamic HeartModelA.I. investment?

Related solutions

Other resources

European Society of Cardiology

Dr. López Fernández discussed echo as a preventive and prognostic tool in an ESC Council’s webinar in January, 2020.

Guidelines

The American Society of Echocardiography and the and the European Association of Cardiovascular Imaging have a prepared an expert consensus statement on the evaluation of cardiac dysfunction related to cancer therapeutics.

Guidelines

The American Society of Echocardiography also provides guidelines for performing comprehensive transthoracic echocardiographic examinations, which includes information on strain imaging and 3D evaluation of LV size and systolic function.

TOMTEC solutions

Cardio-toxicity is one of the most concerning side effects of cancer therapy.  Early detection and monitoring of any cardiac side effects, before visual changes occur, is essential during cancer treatment.

References

 

* Compared to the general population

** Anatomical Intelligence

 

  1. López Fernández T, López Sendón J. How to Improve Therapeutic Strategies to Reduce Cardiotoxicity. Anti-Cancer Treatments and Cardiotoxicity, Elsevier Inc., 2016.
  2. www.escardio.org/The-ESC/Press-Office/Press-releases/Cancer-patients-are-at-higher-risk-of-dying-from-heart-disease-and-stroke
  3. López-Fernández T, et al. Cardio-Onco-Hematology in Clinical Practice. Position Paper and Recommendations. Revista Española de Cardiología (English Edition) Volume 70, Issue 6, June 2017, Pages 474-486
  4. Plana J C, et al. Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography 2014; 27:911-39.
  5. Farsalinos K E, et al. Head-to-Head Comparison of Global Longitudinal Strain Measurements among Nine Difffferent Vendors: The EACVI/ASE Inter-Vendor Comparison Study. Journal of the American Society of Echocardiography Volume 28, Issue 10, October 2015, Pages 1171-1181.e2