Anzeige
Erschienen in:
25.07.2019 | Correspondence
Replied to “Some remarks to SEOM clinical guidelines on cardiovascular toxicity (2018)”
Erschienen in: Clinical and Translational Oncology | Ausgabe 12/2019
Einloggen, um Zugang zu erhaltenExcerpt
We want to thank the authors for their interesting letter; [1] however, we want to explain why we do not recommend in this recent guideline the use of nuclear techniques for cardiovascular monitoring of cancer patients.
1.
The use of radionuclide ventriculography (RVG) is limited by the repeated use of radiation in cancer patients [2].
2.
3.
RVG give us limited information on heart function. Nowadays, cardiotoxicity is not a synonym of left ventricular dysfunction. Using RVG we evaluate left ventricular ejection fraction which is not enough in a great number of patients if we considered the risk of vascular toxicity related with new targeted therapies. TTE offers a complete evaluation of the heart minimizing the number of test needed to perform a global cardiovascular evaluation [5].
4.
5.
Authors refer to a recent consensus document on the appropriate use of image techniques [8]. In this document RVG is considered a good technique to evaluate left ventricular ejection fraction however the same document recognize a great difference between TTE and RVG.
-
In asymptomatic patients at baseline and during follow-up, TTE is the preferred technique over RVG (Score 9 vs 7).
-
In patients with known or suspected heart failure RVG is not recommended and when TTE fails the recommendation is to perform a CMR.
-
RVG is not recommended as initial test in the evaluation of cardiac function in non-heart failure scenarios.