Chemotherapy Induced Heart Failure

Introduction:

Chemotherapy is group of cytotoxic drugs able to kill neoplastic cells[1]. These drugs induce rapid apoptosis, deprivation of growth and suppression of angiogenesis, or a concession in capacity of repairing [2]. They act through disrupting cell division by preventing DNA formation[3]. So, the use of such chemicals is very essential for treating the patients affected with malignant tumors. However, most types of chemotherapeutics target all rapidly dividing cells and are not specific to neoplastic cells[4]. This fact makes chemotherapy toxic to many non targeted organs [5].

Toxicity of heart is one of the worth side effects of cancer treatment, leading to a raise of deaths [6, 7]. Cardiac complications may appear in early phase or late during the course of the disease, and may vary from subclinical myocardial insufficiency to irrevocable heart failure or even causes death[8]. Therefore, the approach now is towards the detection of the highly susceptible patients and provides a method to maximize the benefit of chemotherapeutics usage while minimizing their worth effects or to find another more safe ways to deal with malignant cells [8, 9]. The present summary exposes the existing view of cardiac complications involved in chemotherapeutic usage along with the recent developments in the area.

Definition of cardiotoxicity

Cardiotoxicity has been described by the National Cancer Institute as the toxicity which affects the heart [10]. However, cardiotoxicity has been defined as a decline in ejection fraction of left ventricle [11, 12]. However, there is not yet a clear definition which describes cardiotoxicity that can be applied to all cancer types[12].

Factors affectingthe cardiotoxicity of chemotherapy:

Several studies illustrated that the type of cancer treating agent plays the major role in toxicity pattern [13-15]. Also, dosage of the drug detects the degree of cardiotoxicity [14]. Additionally, the use of drug combinations can be an effective factor.

Patient related factors: such as age, as well as treatment related factors including radiotherapy were found to have a main responsibility in the final cardiac monitoring results [16, 17]. Older age (>65 years) and young (

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