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

Lauren A Baldassarre; Eric H Yang; Richard K Cheng; Jeanne M DeCara; Susan Dent; Jennifer E Liu; Lawrence G Rudski; Jordan B Strom; Paaladinesh Thavendiranathan; Ana Barac; Vlad G Zaha; Chiara Bucciarelli-Ducci; Samer Ellahham; Anita Deswal; Carrie Lenneman; Hector R Villarraga; Anne H Blaes; Roohi Ismail-Khan; Bonnie Ky; Monika J Leja; Marielle Scherrer-Crosbie

doi:10.1093/jnci/djaa177

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

J Natl Cancer Inst. 2021 May 4;113(5):513-522. doi: 10.1093/jnci/djaa177.

Authors

Lauren A Baldassarre¹, Eric H Yang², Richard K Cheng³, Jeanne M DeCara⁴, Susan Dent⁵, Jennifer E Liu⁶, Lawrence G Rudski⁷, Jordan B Strom⁸, Paaladinesh Thavendiranathan⁹, Ana Barac¹⁰, Vlad G Zaha¹¹, Chiara Bucciarelli-Ducci¹², Samer Ellahham¹³, Anita Deswal¹⁴, Carrie Lenneman¹⁵, Hector R Villarraga¹⁶, Anne H Blaes¹⁷, Roohi Ismail-Khan¹⁸, Bonnie Ky¹⁹, Monika J Leja²⁰, Marielle Scherrer-Crosbie²¹

Affiliations

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

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.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 / complications*
COVID-19 / transmission
COVID-19 / virology
Cardiotoxicity / diagnosis
Cardiotoxicity / therapy*
Cardiotoxicity / virology
Cardiovascular Diseases / diagnosis
Cardiovascular Diseases / therapy*
Cardiovascular Diseases / virology
Diagnostic Imaging / methods*
Expert Testimony
Humans
Neoplasms / diagnosis
Neoplasms / therapy*
Neoplasms / virology
SARS-CoV-2 / isolation & purification*

Abstract

Publication types

MeSH terms

Grants and funding