{"entity":{"id":"cardiotoxicity","kind":"term","name":"Cardiotoxicity (LVEF decline, cardiomyopathy)","aka":["cardiac toxicity","cardiotoxic","cardiomyopathy","heart failure","LVEF","left ventricular ejection fraction","ejection fraction","LVEF decline","asymptomatic LVEF decline","echocardiography","echocardiogram","MUGA","cardiac monitoring","cardiac surveillance","cardioprotection","cardioprotective","anthracycline cardiotoxicity","cardiovascular toxicity","cardiovascular events","arterial hypertension","arrhythmia","atrial fibrillation"],"tldr":"Heart damage from cancer treatment: anthracyclines weaken the heart muscle permanently in a dose-related way, trastuzumab does so reversibly, and some kinase inhibitors raise blood pressure or disturb rhythm. Heart function (LVEF) is monitored by ultrasound during treatment.","summary":"Anthracycline cardiomyopathy risk rises steeply above 400-450 mg/m² doxorubicin and with radiotherapy or age; trastuzumab causes asymptomatic LVEF declines in 5-10% and heart failure in 1-4%, more after anthracyclines, monitored every 3 months and usually reversible on stopping. VEGF inhibitors cause hypertension and rarely heart failure; ibrutinib causes atrial fibrillation; immune checkpoint inhibitors cause rare fulminant myocarditis; androgen deprivation and aromatase inhibitors raise cardiovascular risk over years. Cardio-oncology clinics manage risk with ACE inhibitors, beta-blockers, statins and dexrazoxane; anthracycline-free regimens and non-anthracycline ADC payloads reduce exposure. Childhood cancer survivors carry lifelong cardiac risk.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Cardiotoxicity","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Cardiotoxicity"},{"label":"Macmillan: carboplatin and paclitaxel, EC and pembrolizumab (the KEYNOTE-522 regimen)","url":"https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/carboplatin-paclitaxel-ec-pembrolizumab"},{"label":"van Nimwegen et al., cardiovascular disease after Hodgkin lymphoma treatment, 40-year disease risk, JAMA Internal Medicine 2015 (2,524 Dutch patients)","url":"https://doi.org/10.1001/jamainternmed.2015.1180"},{"label":"Lymphoma Action: late effects of lymphoma treatment","url":"https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/late-effects-lymphoma-treatment"}],"tags":[],"related":["anthracycline","myocarditis","late-effects","qt-prolongation"],"cancers":["tnbc","hodgkin-lymphoma","early-stage-classical-hodgkin-lymphoma","advanced-stage-classical-hodgkin-lymphoma","relapsed-refractory-hodgkin-lymphoma","dlbcl","non-hodgkin-lymphoma"],"sections":["supportive-care"],"technologies":["cardio-oncology"],"targets":[],"drugs":["doxorubicin","trastuzumab","ibrutinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["The KEYNOTE-522 regimen for triple-negative breast cancer includes an anthracycline (epirubicin or doxorubicin), so a heart check before treatment and a plan for later checks are worth asking about; the labels warn of heart muscle damage that can appear years later.","Lymphoma: among 2,524 Dutch patients treated for Hodgkin lymphoma before the age of 51 between 1965 and 1995, 1,713 cardiovascular events occurred in 797 people over a median 20 years; at 35 or more years coronary heart disease and heart failure were still 4 to 6 times more common than in the general population, and the 40-year cumulative incidence of cardiovascular disease was 50 per cent. Mediastinal radiotherapy raised the risk of coronary disease, valve disease and heart failure, anthracyclines the risk of valve disease and heart failure, and the effects of radiotherapy, anthracyclines and smoking appeared to add together."],"category":"Side effects"},"route":"/terms/cardiotoxicity/","neighbours":{"term":[{"id":"lymphoma-living-hodgkin-survivorship-screening","kind":"term","name":"After Hodgkin lymphoma: the late effects, and the screening that follows them","route":"/terms/lymphoma-living-hodgkin-survivorship-screening/"},{"id":"anthracycline","kind":"term","name":"Anthracyclines (doxorubicin, epirubicin)","route":"/terms/anthracycline/"},{"id":"lymphoma-decision-beacopp-or-abvd","kind":"term","name":"Escalated chemotherapy or ABVD in advanced Hodgkin lymphoma: more cures, more late harm, and what the interim scan changed","route":"/terms/lymphoma-decision-beacopp-or-abvd/"},{"id":"myocarditis","kind":"term","name":"Immune-related myocarditis","route":"/terms/myocarditis/"},{"id":"late-effects","kind":"term","name":"Late effects and survivorship toxicity","route":"/terms/late-effects/"},{"id":"lymphoma-tx-hodgkin-late-effects","kind":"term","name":"Late effects of Hodgkin lymphoma treatment, and the follow-up that answers them","route":"/terms/lymphoma-tx-hodgkin-late-effects/"},{"id":"qt-prolongation","kind":"term","name":"QT prolongation","route":"/terms/qt-prolongation/"}],"cancer":[{"id":"advanced-stage-classical-hodgkin-lymphoma","kind":"cancer","name":"Advanced-stage classical Hodgkin lymphoma (stage III to IV)","route":"/cancers/advanced-stage-classical-hodgkin-lymphoma/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"early-stage-classical-hodgkin-lymphoma","kind":"cancer","name":"Early-stage classical Hodgkin lymphoma (stage I to II)","route":"/cancers/early-stage-classical-hodgkin-lymphoma/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"relapsed-refractory-hodgkin-lymphoma","kind":"cancer","name":"Relapsed and refractory classical Hodgkin lymphoma","route":"/cancers/relapsed-refractory-hodgkin-lymphoma/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"cardio-oncology","kind":"technology","name":"Cardio-oncology","route":"/technologies/cardio-oncology/"},{"id":"strain-echocardiography-gls","kind":"technology","name":"Strain echocardiography (global longitudinal strain)","route":"/technologies/strain-echocardiography-gls/"},{"id":"cardiac-biomarker-monitoring","kind":"technology","name":"Troponin and natriuretic peptide monitoring during cancer treatment","route":"/technologies/cardiac-biomarker-monitoring/"}],"drug":[{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"ibrutinib","kind":"drug","name":"Ibrutinib","route":"/drugs/ibrutinib/"},{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"}],"trial":[{"id":"ccss","kind":"trial","name":"Childhood Cancer Survivor Study (CCSS)","route":"/trials/ccss/"}]}}