Cardio-oncology: A Review of Heart Failure in Patients with Prior Malignancy and Cancer Therapy-related Cardiac Dysfunction View PDF

^*Kanna Sai Pujitha
Medicine, The University Of Georgia, Tbilisi, Georgia
Sravanthi Dontiboyena
Medicine, The University Of Georgia, Tbilisi, Georgia

^*Corresponding Author:

Kanna Sai Pujitha
Medicine, The University Of Georgia, Tbilisi, Georgia

Published on: 2026-10-16

Abstract

The rising population of cancer survivors, coupled with the expanding arsenal of potentially cardiotoxic cancer therapies, has made heart failure a prevalent and growing concern, necessitating a comprehensive understanding of its prevention, detection, and management within the emerging field of cardio-oncology. This review overviews current literature to provide clinicians and researchers with a cohesive overview of heart failure in patients with prior malignancy and cancer therapy-related cardiac dysfunction (CTRCD). It begins by exploring the diverse pathophysiological mechanisms of CTRCD, from oxidative stress to immunemediated injury, and examines the prevalence and incidence of heart failure among various survivor cohorts. The review then details the clinical presentation and diagnostic challenges unique to this population, emphasizing the critical role of advanced imaging and biomarkers. Current management and treatment strategies are discussed, including pharmacological cardioprotection, lifestyle interventions, and the proven benefits of multidisciplinary cardio-oncology programmes. Finally, it summarizes key clinical trials that inform evidence-based practice, highlighting the protective effects of structured rehabilitation and integrated care models on cardiovascular outcomes. Future research must prioritize large-scale, prospective longitudinal studies to clarify the natural history of CTRCD and validate emerging risk stratification tools. The continued integration of artificial intelligence into diagnostic pathways and the embedding of cardio-oncology principles into standard oncologic care will be essential to personalize treatment and improve long-term outcomes for this vulnerable population

Keywords

Cardio-oncology, Cancer survivors, Cancer therapy-related cardiac dysfunction, Cardiotoxicity, Heart failure, Left ventricular ejection fraction, Multidisciplinary care

Introduction

Cardio-oncology is an interdisciplinary field dedicated to understanding, preventing, and managing cardiovascular complications arising in patients with cancer [1-10]. It encompasses the study of how cancer therapies impact cardiac structure and function, as well as the development of strategies to mitigate these adverse effects. As highlighted by Ogilvie et al. [11], this specialty addresses the complex interplay between malignancy and cardiovascular health, emphasizing the importance of early detection and tailored interventions to improve patient outcomes. The field has evolved to include the assessment of therapy-induced cardiotoxicity, such as heart failure and other cardiac dysfunctions, which are increasingly recognized as significant contributors to morbidity and mortality among cancer survivors.

The significance of cardio-oncology has grown substantially with the advent of more effective cancer treatments that, while improving survival, also pose risks to cardiovascular health [12-21]. CTRCD, including heart failure, has emerged as a major complication that can compromise both quality of life and long-term survival [22]. As cancer survivorship increases, so does the prevalence of cardiovascular sequelae, making it imperative for clinicians to understand the mechanisms, risk factors, and management strategies for these conditions. The rising incidence of CTRCD underscores the need for integrated care models, early detection, and preventive measures to reduce the burden of heart failure in this vulnerable population [22, 23].

This review aims to provide a comprehensive overview of heart failure in patients with prior malignancy and CTRCD. It seeks to elucidate the underlying pathophysiological mechanisms, assess the prevalence and clinical presentation of heart failure among cancer survivors, and evaluate current diagnostic and management strategies. Additionally, the review highlights emerging research, risk stratification tools, and future directions to optimize cardiovascular care in oncology settings. By overviewing current literature, this review intends to inform clinicians and researchers about the critical aspects of cardiooncology, ultimately contributing to improved patient outcomes and the development of personalized, risk-based approaches to prevent and treat cardiac dysfunction in cancer patients.