Article Impact Level: HIGH Data Quality: STRONG Summary of JACC: CardioOncology, 4(3), 354–367. https://doi.org/10.1016/j.jaccao.2022.05.010 Dr. Rahela Aziz-Bose et al
Points
- Before explicit cardiac failure manifests, cardiomyopathy could be clinically hidden for years. As a result, screening at-risk childhood cancer survivors with echocardiography can detect latent illnesses that can be treated to prevent or halt disease progression.
- Regional and global pediatric and internal medical cancer associations released strategies for hazard monitoring, control of changeable coronary risk factors for people living with cancer, and compliance with general public recommendations for optimizing heart health.
- Different modeling studies support the expense of this risk-based strategy for monitoring.
- Prospective interventional studies should ideally be used to guide the strategy for cardiomyopathy detection and treatment for childhood cancer survivors, although there is little available data to support this.
Summary
Cardiopathy is the chief reason for delayed death and morbidity among pediatric cancer survivors. Over half of all childhood cancer survivors (CCS) were treated with recognized cardioprotective substances like anthracycline chemotherapy and/or chest radiation, making them more likely to experience negative cardiac consequences.
Scientifically proven recommendations advise risk-based monitoring for cardiomyopathy, and the therapeutic strategy for anomalies found during the screening of asymptomatic young adults is not well characterized.
By detailing professionals prevailing opinions about cardiomyopathy screening procedures, management strategies, and medical justifications for the therapy of adult childhood cancer survivors with screening-detected anomalies, this study aimed to advance existing guidelines and pinpoint areas of practice disagreement.
The care of the asymptomatic young person with CCS at risk for cardiomyopathy was the subject of three sessions of semi-open-ended questions, which were answered by a multispecialty Delphi panel of forty doctors with experience in thoracic oncology including screening practices, major heart procedures, and biochemical examinations. Consent was outlined as a panel agreement rate of at least ninety percent.
These sessions had a hundred percent response rate. The contentious areas were the criterion for breast radiation dosage to warrant monitoring, the use of cardiovascular biochemical parameters for follow-up of aberrant electrocardiographic results, and the medical treatment of asymptomatic left ventricular systolic dysfunction. They got only 75% agreement.
The specialist approach has complied with current risk-based screening recommendations. Some management strategies for anomalies identified by screening ultrasonography are still debatable. In the lack of guidelines tailored specifically for young adult childhood cancer survivors, the explanations provided by experts for different treatments may assist direct clinical decisions.
Link to the article: https://www.jacc.org/doi/10.1016/j.jaccao.2022.05.010
References Aziz, -Bose Rahela, Margossian, R., Ames, B. L., Moss, K., Ehrhardt, M. J., Armenian, S. H., Yock, T. I., Nekhlyudov, L., Williams, D., Hudson, M., Nohria, A., & Kenney, L. B. (2022). Delphi panel consensus recommendations for screening and managing childhood cancer survivors at risk for cardiomyopathy. JACC: CardioOncology, 4(3), 354–367. https://doi.org/10.1016/j.jaccao.2022.05.010
