Welcome to the Rising Stars in Cardio-Oncology Special Focus Issue

Keywords:

• cardio-oncology
• cardiology
• cardiotoxicity
• cardiovascular disease
• cardiovascular dysfunction
• ESC guidelines

It is my great pleasure to welcome you to the ‘Rising Stars in Cardio-Oncology’ Special Focus Issue of Future Cardiology. With this issue, we wanted to put the spotlight on talented early career researchers emerging in the field of cardio-oncology and bring attention to a relatively new area within cardiovascular research.

Over the past decade, the field of cardio-oncology has emerged in response to a growing body of evidence highlighting the intricate connections between cardiovascular disease (CVD) and cancer. Cardiovascular dysfunction, which is associated with the increasing potency of cancer therapies like chemotherapy and radiotherapy, has become a leading cause of morbidity and mortality among cancer patients [1]. This condition, known as cancer therapy-related cardiovascular toxicity (CTR-CVT), can inadvertently result from treatments that enhance cancer prognosis and survival, and it can manifest at any stage, sometimes even years into the treatment process. Consequently, cardio-oncology primarily focuses on the identification, monitoring, treatment and prevention of cardiovascular dysfunction in cancer patients.

In a recent publication, a new 5-tier classification system for cardio-oncology syndromes was introduced, further highlighting the complex direct and indirect associations between cancer and CVD, as summarized in  Figure 1 [1].

The articles featured in this issue provide insight into a variety of areas within cardio-oncology including side effects of radiation therapy, imaging techniques to assess right ventricular function following cancer treatment and the relationship between anthracyclines and cardiovascular complications.

A brief overview of the articles

To kick off this Special Focus issue, we have a Conference Report by Guest Editor, M Camilli. The report centers on the recent Cardio-Oncology symposium conducted during the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Annual Meeting. The conference focused primarily on the diagnosis, management and prevention of cardiovascular toxicity resulting from cancer drugs, particularly cardiac dysfunction induced by anthracyclines. In this report, M Camilli highlights some of the issues facing cardio-oncology that were discussed during the conference and sheds light on the ongoing efforts being made to address them [2].

Next up, is a Case Report by Patel et al. that explores a case of nonbacterial thrombotic endocarditis (NBTE) triggered by ovarian carcinoma. The report outlines a successful management approach involving anticoagulation, chemotherapy and surgical removal of the malignancy, and underscores the importance of considering NBTE in cancer patients presenting with thromboembolic events [3].

Continuing on, we present a Case Series by Coma et al. that sheds light on some uncommon and long-term cardiovascular side effects of thoracic radiation therapy. This series delves into the dynamics of pericardial disorders and valvular heart disease as a result of radiotherapy, highlighting two unique cases – one describing acute pericarditis during treatment and the other featuring a rare combination of pericardial and valvular involvement in a long-term survivor. These cases underscore the importance of early diagnosis, multidisciplinary care and individualized treatment in managing these uncommon radiation-induced cardiac conditions [4].

The penultimate article is a Special Report by Samimi et al. that explores the impact of cancer therapy on right ventricular (RV) function, an often overlooked aspect of cancer therapy-related cardiac dysfunction (CTRCD). This report presents the challenges posed by traditional echocardiography in assessing RV function, and explores alternative parameters and imaging techniques, including 3D echocardiography, stress echocardiography and cardiac magnetic resonance imaging. Through this review, readers will gain valuable insights into the importance of monitoring biventricular function postchemotherapy for the early detection of subclinical CTRCD and potential RV-specific changes, that will ultimately enhance patient care [5].

Rounding out this Special Focus Issue we have a Review by Clayton and Maurer that offers a comprehensive overview of the relationship between anthracyclines, a common class of chemotherapeutic agents and cardiovascular complications. This article highlights the need for research into interventions that can enhance the wellbeing of cancer survivors who face heightened cardiovascular risks due to anthracycline chemotherapy. The review delves into the significant role of anthracycline-induced vascular dysfunction, a known precursor to cardiovascular diseases, while also highlighting its connection to impaired cognitive function in treated patients. By investigating potential strategies to improve vascular dysfunction as well as cardiovascular and cognitive health among cancer survivors, this article not only bridges critical gaps in research but also illuminates future prospects within the ever-evolving field of cardio-oncology [6].

Figure 1. A 5-tier classification system for cardio-oncology syndromes.

Taken from [1], CC-BY license http://creativecommons.org/licenses/by/4.0/.

CV: Cardiovascular.

A note to our readers and authors

We hope that you, our readers, find the articles within this issue to be informative and highlight an emerging but important field of cardiovascular medicine. We would also like to express our gratitude to the esteemed Guest Editor, M Camilli, Medical Cardiologist at Catholic University of the Sacred Heart (Rome, Italy) as well as to the ‘rising stars’ who took the time to contribute articles, making this Special Focus Issue possible.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

A Cannon is, and J Neill was, an employee of Future Medicine Ltd. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.