Echocardiography and Alternative Cardiac Imaging Strategies for Long-Term Cardiotoxicity Surveillance of Cancer Survivors Treated with Chemotherapy and/or Radiation Exposure

Cardiotoxicity from chemotherapy is a leading cause of morbidity and mortality in cancer survivors. Cardiotoxic effects include left ventricular systolic dysfunction, coronary artery disease, hypertension, bradycardia, arrhythmias, pericardial disease, valvular disease, and radiation-induced restrictive cardiomyopathy. Noninvasive cardiac imaging has been at the forefront of detecting cardiotoxicity in patients receiving chemotherapeutic agents known to adversely affect cardiac structure and function. Regimens for cardiotoxicity surveillance prior to and during chemotherapy administration have been proposed; however, optimal screening for and treatment of long-term cancer survivors have yet to be clarified. This review focuses on the most common imaging modalities for assessing cardiac dysfunction along with newer imaging technologies, and reviews suggested long-term surveillance strategies in cancer survivors following chemotherapy and radiation therapy.