Managing Cancer Patients and Survivors With Advanced Heart Failure

Abstract

Purpose of review The number of cancer patients grows globally. An important subset may develop heart failure. Recent findings A paucity of data exists regarding outcomes and response to traditional intervention in cancer patients who develop heart failure. Advanced HF treatments in this population require special considerations. Since cancer treatment schedules are anticipated, emphasis should be placed on preventive interventions. Once left ventricular dysfunction ensues, early recognition and prompt treatment of heart failure may improve prognosis. Small studies have shown that guideline-directed medical therapies, cardiac resynchronization therapy, and implantable cardiac defibrillators are equally beneficial in cancer patients yet underutilized as a result of late recognition of heart failure and/or misconception of oncologic prognosis. Additionally, in carefully selected cancer survivors, clinical outcome after implantation of a left ventricular assist device and heart transplantation are comparable with other causes of heart failure. Cancer survivors with acceptable prognosis should be evaluated for HF therapies in a timely manner. There remains an urgent need for larger-scale longitudinal studies to determine the best treatment strategies for heart failure in this population.