Cardiovascular immune-related adverse events: Evaluation, diagnosis and management

Asia-Pacific Journal of Clinical Oncology
Yingxian Liu, Wei Wu

Abstract

Cardiotoxicities are associated with immune checkpoint inhibitor (ICI) therapy. Recent case series and retrospective studies have shown that cardiac immune-related adverse events (irAEs) are rare but potentially fatal complications of immunotherapy, with various underlying risk factors such as combinations of different ICIs. High mortality rates and overreactive inflammation have been observed with ICI-associated cardiotoxicities, highlighting the necessity of baseline and serial evaluations and the identification and management of cardiac irAEs as early as possible. The clinical presentations of irAEs range from asymptomatic cardiac biomarker elevation, myocarditis and pericardial diseases to heart failure and mild to fatal arrhythmia. Troponin measurement and electrocardiogram are sensitive initial tests, whereas cardiac magnetic resonance imaging and endomyocardial biopsy are both gold standard components of the diagnostic criteria. Close monitoring and timely consultation with a cardiologist are important for the diagnosis of ICI-related cardiotoxicities, with decisions of stopping or rechallenging ICIs and strategies to manage heart injuries. Treatment principles are made according to risk stratifications. The first-line m...Continue Reading

References

Apr 25, 2009·Journal of the American College of Cardiology·Matthias G FriedrichUNKNOWN International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis
Mar 1, 2012·Journal of the American College of Cardiology·Ingrid KindermannMichael Böhm
Sep 21, 2013·Circulation. Cardiovascular Imaging·Matthias G Friedrich, François Marcotte
Oct 16, 2013·Journal of Magnetic Resonance Imaging : JMRI·Giovanni Donato AquaroMassimo Lombardi
Jun 3, 2014·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Vanessa M FerreiraStefan Neubauer
Dec 9, 2014·The New England Journal of Medicine·Stephen M AnsellPhilippe Armand
Feb 24, 2015·Journal for Immunotherapy of Cancer·Benjamin P GeislerDavid R Schwartz
Apr 23, 2015·Journal for Immunotherapy of Cancer·Heinz LäubliAlfred Zippelius
Apr 29, 2015·Case Reports in Oncological Medicine·Seongseok YunSara Motamed
Jun 2, 2015·The New England Journal of Medicine·James LarkinJedd D Wolchok
Sep 16, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J NaidooJ D Wolchok
Nov 26, 2015·Nature Reviews. Clinical Oncology·Mark J SmythMichele W L Teng
Feb 4, 2016·Journal of the National Cancer Institute·Michael B Atkins, James Larkin
Feb 15, 2016·Cancer Treatment Reviews·Lavinia SpainJames Larkin
Apr 16, 2016·Journal of the American College of Cardiology·Philipp LurzMatthias Gutberlet
Apr 17, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Lisa ZimmerLucie M Heinzerling
May 5, 2016·Nature Reviews. Clinical Oncology·Celine BoutrosCaroline Robert
Jul 2, 2016·JAMA Oncology·Claire F FriedmanMichael A Postow
Aug 16, 2016·International Journal of Cardiology·Jennifer NesfederSteven Domsky
Aug 16, 2016·International Journal of Cardiology·Robert D Anderson, Matthew Brooks
Aug 25, 2016·Cardiology·Igal Kushnir, Ido Wolf
Aug 30, 2016·Journal of Magnetic Resonance Imaging : JMRI·Giovanni Donato AquaroUNKNOWN working group “Applicazioni della Risonanza Magnetica” of the Italian Society of Cardiology
Nov 3, 2016·The New England Journal of Medicine·Douglas B JohnsonJavid J Moslehi
Dec 4, 2016·International Journal of Cardiology·Enrico AmmiratiPatrizia Pedrotti
Jan 10, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jeffrey S WeberCaroline Robert
Apr 13, 2017·Current Treatment Options in Cardiovascular Medicine·Varun JainAna Barac
Jun 15, 2017·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Chana WeinstockRichard Pazdur
Aug 20, 2017·Neurology·Shigeaki SuzukiMakoto Matsui
Aug 22, 2017·The Canadian Journal of Cardiology·Neeti ReddyCezar Iliescu
Aug 26, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Dirk SchadendorfMichael A Postow
Sep 9, 2017·JAMA : the Journal of the American Medical Association·Suzanne L Topalian
Sep 12, 2017·The New England Journal of Medicine·Jedd D WolchokJames Larkin
Sep 16, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Mario SznolJedd D Wolchok
Sep 25, 2017·Annals of Translational Medicine·Diwakar JainWilbert Aronow
Oct 14, 2017·Journal of the American College of Cardiology·Christoph GräniRaymond Y Kwong
Oct 28, 2017·Journal of Immunotherapy·Azadeh Tajmir-RiahiLucie Heinzerling
Nov 22, 2017·Journal for Immunotherapy of Cancer·Timothy G NorwoodRobert M Conry
Nov 23, 2017·Journal for Immunotherapy of Cancer·I PuzanovUNKNOWN Society for Immunotherapy of Cancer Toxicity Management Working Group

❮ Previous
Next ❯

Citations

Oct 3, 2020·International Journal of Molecular Sciences·Grzegorz SławińskiEwa Lewicka
Jun 17, 2021·BMJ Supportive & Palliative Care·Ana Filipa Palma Dos ReisAndrew Wilcock

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy

Software Mentioned

Vigibase

Related Concepts

Related Feeds

Cardiotoxicity

Cardiotoxicity refers to the muscle damage or dysfunction of heart electrophysiology caused by drug intake or due to disease complications. It is a well-known side effect of several cytotoxic drugs, especially of the anthracyclines and can lead to long term morbidity. Here is the latest research.

Anti-inflammatory Treatments

A drug or substance that reduces inflammation (redness, swelling, and pain) in the body. Anti-inflammatory agents block certain substances in the body that cause inflammation and swelling. Discover the latest research on anti-inflammatory treatments here

Related Papers

Frontiers in Cardiovascular Medicine
Kazuko Tajiri, Masaki Ieda
Rheumatic Diseases Clinics of North America
Laura C CappelliClifton O Bingham
© 2021 Meta ULC. All rights reserved