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How do strain & strain rate aide in the Dx and Tx of Cardio-oncology patients?

This type of evaluation would be done before during and after cancer treatment at intervals determined by the cardio-oncology team. It aids in diagnosis of cardiotoxicity by detecting myocyte deformation before LV dysfunction can be detected by other methods and therefore aids in determining appropriate treatment methods and/or drugs both for cancer and any resultant cardiac dysfunction

References

Work Citied

NCBI

Collier, P., Koneru, S., Tamarappoo, B., & Griffin, B. (2015). Strain imaging to detect cancer therapeutics-related cardiac dysfunction: are we there yet? Future Cardiology, 11(4), 401–405. http://doi.org/10.2217/fca

Dandel, Michael, et al. “Strain and Strain Rate Imaging by Echocardiography – Basic Concepts and Clinical Applicability.” Current Cardiology Reviews, Bentham Science Publishers Ltd, 5 May 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2805816/.

Larsen, C. M., & Mulvagh, S. L. (2017). Cardio-oncology: what you need to know now for clinical practice and echocardiography. Echo Research and Practice, 4(1), R33–R41. http://doi.org/10.1530/ERP-17-0013

PMC

Social

PLATFORMS

Work Citied

Cardio-Oncology

Pam Pacana

CVT 224

Speciality Procedure

Summary

Summary

what is Cardio-Oncology?

Within the treatment of cancer lies a danger unrelated to malignancy. While chemotherapeutic drugs and radiation therapy have helped countless cancer patients beat cancer, due to their cardiotoxic nature, too often they have wreaked havoc on those patients’ cardiovascular systems, causing complications that include “heart failure, coronary artery disease, peripheral vascular disease, thromboembolism, pericardial disease and valvular heart disease” (Larsen & Mulvagh, 2017). Because of these cardiovascular complications and risks, cardio-oncology is becoming a fast-growing, in-demand field, revolving around a multidisciplinary team of specialists (cardiologist, oncologist, hematologist) “working together for the prevention, early detection and management of cardiovascular disease in cancer patients throughout all stages of cancer therapy and in the survivorship period” (Larsen & Mulvagh, 2017).

Lancaster PA

Brenda Jorge

Lara Strickler

In search of a better means of early detection of cardiotoxicity, studies have found that left-ventricular strain, “defined as the magnitude of regional change in myocardial deformation (percent change in dimension)” (Collier, Koneru, Tamarappoo & Griffin, 2015), and strain-rate, especially global longitudinal strain (GLS), are good predictors of cardiotoxicity and can reveal myocardial deformation before LV dysfunction has been demonstrated via LV EF assessment. This is crucial to the prognosis of cardio-oncology patients, as early detection and prompt initiation of appropriate heart failure treatment increases the probability of LVEF recovery as well as a decrease in adverse cardiac events or outcomes.

Echocardiography is one of the key imaging techniques used in acquiring a baseline assessment of a patient’s heart before beginning chemotherapy/radiation therapy, as well as in follow-up scans during and after treatment, the frequency of which depends on many factors including patient’s age, type of treatment, dosage, etc. Though a common and generally favored measure of cardiac assessment is the monitoring of left-ventricular ejection fraction, this poses a problem for the purposes of preventing cardiotoxicity because, as Larsen & Mulvagh point out, “changes in LV EF usually occur at a later stage when significant toxicity has already occurred” (2017).

William

Merkel Cell

Cancer Patient

Defined

Patient

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