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Moving towards establishing centres of excellence in cardiac amyloidosis: an International Cardio-Oncology Society statement
Cheng, Richard; Kittleson, Michelle M; Wechalekar, Ashutosh D; Alvarez-Cardona, Jose; Mitchell, Joshua D; Scarlatelli Macedo, Ariane Vieira; Dutra, Joao Pedro Passos; Campbell, Courtney M; Liu, Jennifer E; Landau, Heather J; Davis, Margot K; Morrissey, Siobhain; Casselli, Stephen; Lousada, Isabelle; Seabra-Garcez, Juliane Dantas; Szor, Roberta Shcolnik; Ganatra, Sarju; Trachtenberg, Barry; Maurer, Mathew S; Stockerl-Goldstein, Keith; Lenihan, Daniel
The prevalence of amyloidosis has been increasing, driven by a combination of improved awareness, evolution of diagnostic pathways, and effective treatment options for both transthyretin and light chain amyloidosis. Due to the complexity of amyloidosis, centralised expert providers with experience in delineating the nuances of confirmatory diagnosis and management may be beneficial. There are many potential benefits of a centre of excellence designation for the treatment of amyloidosis including recognition of institutions that have been leading the way for the optimal treatment of this condition, establishing the expectations for any centre who is engaging in the treatment of amyloidosis and developing cooperative groups to allow more effective research in this disease space. Standardising the expectations and criteria for these centres is essential for ensuring the highest quality of clinical care and community education. In order to define what components are necessary for an effective centre of excellence for the treatment of amyloidosis, we prepared a survey in cooperation with a multidisciplinary panel of amyloidosis experts representing an international consortium. The purpose of this position statement is to identify the essential elements necessary for highly effective clinical care and to develop a general standard with which practices or institutions could be recognised as a centre of excellence.
PMID: 38267197
ISSN: 1468-201x
CID: 5625022
In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database
Leiva, Orly; Alvarez-Cardona, Jose; How, Joan; Brunner, Andrew; Hobbs, Gabriela
Background: Myeloproliferative neoplasms (MPNs) are chronic leukemias associated with increased risk of cardiovascular (CV) events. Prior studies suggest patients with MPN are at increased risk of HF. Additionally, pre-clinical murine models harboring the JAK2 mutation, the most common driver mutation in MPNs, have shown accelerated adverse cardiac remodeling in myocardial infarction and pressure overload HF models. However, clinical outcomes, including in-hospital and readmission outcomes, of patients with MPN admitted for HF have not been well characterized. Methods: Patients hospitalized for HF with and without MPN were identified using the 2017 and 2018 National Readmission Database. Propensity score matching (PSM) was performed to match 1 MPN with 10 non-MPN controls. Outcomes were in-hospital death, 90-day CV-related, HF-related, and all-cause readmissions. Logistic regression and Cox proportional hazards regression models were used to estimate risk of in-hospital death and 90-day readmission outcomes, respectively. Results: After PSM, 4,626 patients with MPN were matched with 46,260 without. Patients with MPN were associated with increased risk of in-hospital death (OR 1.17, 95% CI 1.00 "“ 1.35), 90-day CV-related (HR 1.10, 95% CI 1.02 "“ 1.18) and all-cause (HR 1.24, 95% CI 1.17 "“ 1.31) but not HF-related (HR 1.05, 95% CI 0.97 "“ 1.14) readmissions. Conclusion: Among patients hospitalized for HF, MPN was associated with increased risk of in-hospital death, and 90-day CV-related readmissions (driven primarily by thrombotic readmissions). Further investigation is needed in order to improve outcomes in patients with MPN and HF.
SCOPUS:85178430147
ISSN: 2352-9067
CID: 5621012
Cardiomyopathy/heart failure prevention before cancer therapy
Chapter by: Alvarez-Cardona, Jose; Lenihan, DJ
in: Cardio-Oncology Practice Manual: A Companion to Braunwald’s Heart Disease by Hermann, Joerg [Ed]
[S.l.] : Elsevier, 2022
pp. ?-
ISBN: 9780323681360
CID: 5364072
Cardiomyopathy/heart failure prevention and management
Chapter by: Alvarez-Cardona, Jose; Lenihan, DJ
in: Cardio-Oncology Practice Manual: A Companion to Braunwald’s Heart Disease by Hermann, Joerg [Ed]
[S.l.] : Elsevier, 2022
pp. ?-
ISBN: 9780323681360
CID: 5364092
Cardiac dysfunction : smal-molecule kinase inhibitors, immune-based therapies, and proteasome inhibitors
Chapter by: Jimenez, J; Alvarez-Cardona, Jose
in: Washington Manual of Cardio-Oncology : A Practical Guide for Improved Cancer Survivorship by Lenihan, Daniel; et al [Eds]
[S.l] : Wolters Kluwer, 2022
pp. 48-63
ISBN: 9781975180447
CID: 5364132
A practical approach to the evaluation of cardio-oncology patient
Chapter by: Lenihan, DJ; Mitchell, J; Alvarez-Cardona, Jose
in: Washington Manual of Cardio-Oncology : A Practical Guide for Improved Cancer Survivorship by Lenihan, Daniel; et al [Eds]
[S.l] : Wolters Kluwer, 2022
pp. 1-25
ISBN: 9781975180447
CID: 5364122
Cardiomyopathy/heart failure, myocarditis, and Takotsubo's during cancer therapy
Chapter by: Alvarez-Cardona, Jose; Lenihan, DJ
in: Cardio-Oncology Practice Manual: A Companion to Braunwald’s Heart Disease by Hermann, Joerg [Ed]
[S.l.] : Elsevier, 2022
pp. ?-
ISBN: 9780323681360
CID: 5364112
Cancer survivors and advanced heart failure therapies
Chapter by: Kopecky, BJ; Alvarez-Cardona, Jose
in: Washington Manual of Cardio-Oncology : A Practical Guide for Improved Cancer Survivorship by Lenihan, Daniel; et al [Eds]
[S.l] : Wolters Kluwer, 2022
pp. ?-
ISBN: 9781975180447
CID: 5364142
Role of cardiovascular magnetic resonance in early detection and treatment of cardiac dysfunction in oncology patients
Vallabhaneni, Srilakshmi; Zhang, Kathleen W; Alvarez-Cardona, Jose A; Mitchell, Joshua D; Steen, Henning; Woodard, Pamela K; Lenihan, Daniel J
The purpose of this review is to provide an overview of the essential role that cardiovascular magnetic resonance (CMR) has in the field of cardio-oncology. Recent findings: CMR has been increasingly used for early identification of cancer therapy related cardiac dysfunction (CTRCD) due to its precision in detecting subtle changes in cardiac function and for myocardial tissue characterization. Summary: CMR is able to identify subclinical CTRCD in patients receiving potentially cardiotoxic chemotherapy and guide initiation of cardio protective therapy. Multiparametric analysis with myocardial strain, tissue characterization play a critical role in understanding important clinical questions in cardio-oncology.
PMID: 33982196
ISSN: 1875-8312
CID: 5294902
Cardiovascular Manifestations From Therapeutic Radiation: A Multidisciplinary Expert Consensus Statement From the International Cardio-Oncology Society
Mitchell, Joshua D; Cehic, Daniel A; Morgia, Marita; Bergom, Carmen; Toohey, Joanne; Guerrero, Patricia A; Ferencik, Maros; Kikuchi, Robin; Carver, Joseph R; Zaha, Vlad G; Alvarez-Cardona, Jose A; Szmit, Sebastian; Daniele, Andrés J; Lopez-Mattei, Juan; Zhang, Lili; Herrmann, Jörg; Nohria, Anju; Lenihan, Daniel J; Dent, Susan F
Radiation therapy is a cornerstone of cancer therapy, with >50% of patients undergoing therapeutic radiation. As a result of widespread use and improved survival, there is increasing focus on the potential long-term effects of ionizing radiation, especially cardiovascular toxicity. Radiation therapy can lead to atherosclerosis of the vasculature as well as valvular, myocardial, and pericardial dysfunction. We present a consensus statement from the International Cardio-Oncology Society based on general principles of radiotherapy delivery and cardiovascular risk assessment and risk mitigation in this population. Anatomical-based recommendations for cardiovascular management and follow-up are provided, and a priority is given to the early detection of atherosclerotic vascular disease on imaging to help guide preventive therapy. Unique management considerations in radiation-induced cardiovascular disease are also discussed. Recommendations are based on the most current literature and represent a unanimous consensus by the multidisciplinary expert panel.
PMCID:8463721
PMID: 34604797
ISSN: 2666-0873
CID: 5294922