Cardiovascular Care of the Oncology Patient During COVID-19: An Expert Consensus Document From the ACC Cardio-Oncology and Imaging Councils

Author:

Baldassarre Lauren A1ORCID,Yang Eric H2ORCID,Cheng Richard K3,DeCara Jeanne M4ORCID,Dent Susan5,Liu Jennifer E6ORCID,Rudski Lawrence G7ORCID,Strom Jordan B8ORCID,Thavendiranathan Paaladinesh9ORCID,Barac Ana10ORCID,Zaha Vlad G11ORCID,Bucciarelli-Ducci Chiara12ORCID,Ellahham Samer13ORCID,Deswal Anita14ORCID,Lenneman Carrie15ORCID,Villarraga Hector R16ORCID,Blaes Anne H17ORCID,Ismail-Khan Roohi18ORCID,Ky Bonnie19ORCID,Leja Monika J20,Scherrer-Crosbie Marielle21ORCID

Affiliation:

1. Affiliations of authors: Section of Cardiovascular Medicine, Department of Medicine, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA

2. UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

3. Cardio-Oncology Program, Department of Medicine, Division of Cardiology and Department of Radiology, University of Washington, Seattle, WA, USA

4. Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA

5. Duke Cancer Institute, Department of Medicine, Duke University, Durham, NC, USA

6. Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

7. Azrieli Heart Center, Department of Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada

8. Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

9. Ted Rogers Program in Cardiotoxicity Prevention, Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada

10. Medstar Heart and Vascular Institute, Georgetown University, Washington, DC, USA

11. Cardio-Oncology Program, Harold C. Simmons Comprehensive Cancer Center, Division of Cardiology, Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA

12. Bristol Heart Institute, Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Trust and University of Bristol, Bristol, UK

13. Heart and Vascular Institute, Cleveland Clinic-Abu Dhabi, Abu Dhabi, United Arab Emirates

14. Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

15. Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

16. Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA

17. Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN, USA

18. Cardio-Oncology Program, Division of Oncologic Sciences, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL, USA

19. Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

20. Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA

21. Division of Cardiology, Department of Medicine, Perelman School of Medicine, University  of Pennsylvania, Philadelphia, PA, USA

Abstract

Abstract In response to the coronavirus disease 2019 (COVID-19) pandemic, the Cardio-Oncology and Imaging Councils of the American College of Cardiology offers recommendations to clinicians regarding the cardiovascular care of cardio-oncology patients in this expert consensus statement. Cardio-oncology patients—individuals with an active or prior cancer history and with or at risk of cardiovascular disease—are a rapidly growing population who are at increased risk of infection, and experiencing severe and/or lethal complications by COVID-19. Recommendations for optimizing screening and monitoring visits to detect cardiac dysfunction are discussed. In addition, judicious use of multimodality imaging and biomarkers are proposed to identify myocardial, valvular, vascular, and pericardial involvement in cancer patients. The difficulties of diagnosing the etiology of cardiovascular complications in patients with cancer and COVID-19 are outlined, along with weighing the advantages against risks of exposure, with the modification of existing cardiovascular treatments and cardiotoxicity surveillance in patients with cancer during the COVID-19 pandemic.

Funder

American Heart Association

NIH

NHLBI

The Cancer Prevention Research Institute of Texas

University Hospitals Bristol NHS Foundation Trust

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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