Cardio-Oncology Department
Cancer and cardiovascular disease are the two most common non communicable diseases which cause the highest global mortality. In recent years, the growing volume of elderly population and improved overall survival has led to co-existence of cardiovascular disease and cancer in a large group of patients. Moreover, cardiovascular events have been recognized as a major cause of mortality among cancer survivors, which in some cancer types might actually exceed the mortality rate related to re-occurrence of the baseline malignancy. Addressing the challenges associated with caring for these patients has led to the development of a new branch of medicine called cardio-oncology. The main purpose of this specialty is to consider both aspects of cardiology and oncology in a patient, and create a bridge between the two fields in order to make the best decisions regarding prevention, monitoring, and treatment of the diseases.
As a tertiary cardiovascular center, this center has dealt with a significant number of cancer patients referred for cardiovascular evaluation in daily practice. However, this experience has recently been structuralized and the cardio-oncology discipline has been launched in Shaheed Rajaie Cardiovascular Medical and Research Center.
Since then, many patients have been visited for oncology related cardiovascular assessment at our center which 70 percent of them suffering from breast cancer. GI cancers patients are the next most common group of patients.
Currently cardio-oncology and cardiology consult services are available in a weekly basis clinic, however imaging workup of the patients is performed on a daily basis.
Three dimensional echocardiographic evaluation of LVEF and strain imaging are routinely used for serial assessment of breast cancer patients and other patients which are referred for cardiotoxicity evaluation. CMR is also available in the center which is mostly reserved for equivocal echocardiographic results and research purposes.
Several investigational projects are also being run in the department mainly focusing on earlier and more sensitive detection of cardiotoxicity, namely evaluation of additive value of circumferential strain imaging and use of heart model software compared to routine 3 dimensional evaluations of left ventricular function among patients undergoing Anthracycline and other cardio-toxic agents’ treatment.
Considering very limited number of specialists currently working in this field as well as inadequate expertise, the curriculum for a cardio-oncology fellowship training in the center is being prepared based on the latest international recommendations. Within this program we will try to expand the knowledge of cardio-oncology and improve the clinical care of cancer patients in an organized manner, in order to decrease the cardiovascular burden of cancer patients.