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      British Society for Echocardiography and British Cardio-Oncology Society guideline for transthoracic echocardiographic assessment of adult cancer patients receiving anthracyclines and/or trastuzumab

      other
      , MBChB (Hons) MD 1 , , MBBS MSc PhD 2 , 3 , , MD MSCE 4 , , MBBS PhD MPH 5 , , PhD 6 , , MB ChB MSc 7 , , MA MD 8 , , MA MD 9 , , PhD 10 , , BA BM BCh DPhil 11 , , MB ChB MSc MD 2 , , MBBS 13 , , MB ChB PhD 14 , , MBBS 15 , , MA MD 16 , , BSc PhD BM BCh 17 , , MBBS MA PhD 2 , , MB BCh MMedSci MD 18 , , MD 19 , , BSc 6 , , MD PhD 16 , , MD 20 , 21 , the British Society of Echocardiography (BSE) and the British Society of Cardio-Oncology (BCOS)
      Echo Research and Practice
      Bioscientifica Ltd
      anthracycline, echocardiography, guidelines, HER2 therapy, imaging

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          Abstract

          The subspecialty of cardio-oncology aims to reduce cardiovascular morbidity and mortality in patients with cancer or following cancer treatment. Cancer therapy can lead to a variety of cardiovascular complications, including left ventricular systolic dysfunction, pericardial disease, and valvular heart disease. Echocardiography is a key diagnostic imaging tool in the diagnosis and surveillance for many of these complications. The baseline assessment and subsequent surveillance of patients undergoing treatment with anthracyclines and/or human epidermal growth factor (EGF) receptor (HER) 2-positive targeted treatment (e.g. trastuzumab and pertuzumab) form a significant proportion of cardio-oncology patients undergoing echocardiography. This guideline from the British Society of Echocardiography and British Cardio-Oncology Society outlines a protocol for baseline and surveillance echocardiography of patients undergoing treatment with anthracyclines and/or trastuzumab. The methodology for acquisition of images and the advantages and disadvantages of techniques are discussed. Echocardiographic definitions for considering cancer therapeutics-related cardiac dysfunction are also presented.

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          Most cited references87

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          2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

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            Re-epithelialization and immune cell behaviour in an ex vivo human skin model

            A large body of literature is available on wound healing in humans. Nonetheless, a standardized ex vivo wound model without disruption of the dermal compartment has not been put forward with compelling justification. Here, we present a novel wound model based on application of negative pressure and its effects for epidermal regeneration and immune cell behaviour. Importantly, the basement membrane remained intact after blister roof removal and keratinocytes were absent in the wounded area. Upon six days of culture, the wound was covered with one to three-cell thick K14+Ki67+ keratinocyte layers, indicating that proliferation and migration were involved in wound closure. After eight to twelve days, a multi-layered epidermis was formed expressing epidermal differentiation markers (K10, filaggrin, DSG-1, CDSN). Investigations about immune cell-specific manners revealed more T cells in the blister roof epidermis compared to normal epidermis. We identified several cell populations in blister roof epidermis and suction blister fluid that are absent in normal epidermis which correlated with their decrease in the dermis, indicating a dermal efflux upon negative pressure. Together, our model recapitulates the main features of epithelial wound regeneration, and can be applied for testing wound healing therapies and investigating underlying mechanisms.
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              Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

              The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
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                Author and article information

                Journal
                Echo Res Pract
                Echo Res Pract
                echo
                Echo Research and Practice
                Bioscientifica Ltd (Bristol )
                2055-0464
                March 2021
                26 February 2021
                : 8
                : 1
                : G1-G18
                Affiliations
                [1 ]Cardio-Oncology Service , Liverpool Heart and Chest NHS Foundation Trust, Liverpool, UK
                [2 ]Cardio-Oncology Service , Barts Heart Centre, Barts Health NHS Trust, London, UK
                [3 ]Cardio-Oncology Service , Hatter Cardiovascular Research Institute, University College London and University College London Hospitals NHS Foundation Trust, London, UK
                [4 ]Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania, USA
                [5 ]Baker Heart and Diabetes Institute , Melbourne, Australia
                [6 ]University Hospital South Manchester NHS Foundation Trust , Manchester, UK
                [7 ]East Suffolk and North Essex NHS Foundation Trust , Colchester, UK
                [8 ]University Hospitals Birmingham NHS Foundation Trust , Birmingham, UK
                [9 ]North West Anglia Foundation Trust , UK
                [10 ]Liverpool John Moores University , Liverpool, UK
                [11 ]University Hospitals of Leicester NHS Trust , Leicester, UK
                [12 ]Royal Marsden NHS Foundation Trust and Institute of Cancer Research , London, UK
                [13 ]Imperial College Healthcare NHS Trust , London, UK
                [14 ]The Shrewsbury and Telford Hospital NHS Trust , Shrewsbury, UK
                [15 ]West Suffolk NHS Foundation Trust , Bury St Edmunds, UK
                [16 ]Royal Brompton and Harefield NHS Foundation Trust and Imperial College London , London, UK
                [17 ]The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle, UK
                [18 ]Belfast Health and Social Care Trust , Belfast, UK
                [19 ]Royal Liverpool and Broadgreen University Hospitals NHS Trust , Liverpool, UK
                [20 ]Department of Cardiology , Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
                [21 ]Department for Health , University of Bath, Bath, UK
                Author notes
                Correspondence should be addressed to R Dobson or A K Ghosh: Rebecca.dobson@ 123456lhch.nhs.uk or arjun.ghosh@ 123456nhs.net

                *(R Dobson and A K Ghosh contributed equally to this work)

                Anju Nohria, MD, served as the Editor-in-Chief for this paper. Juan Carlos Plana Gomez, MD, served as the Guest Associate Editor for this paper. The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate.

                Article
                ERP-21-0001
                10.1530/ERP-21-0001
                8052569
                34106116
                490fd0ac-ef8f-4095-a275-fe0bc504f067
                © 2021 The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 26 February 2021
                : 26 February 2021
                Categories
                Guidelines and Recommendations

                anthracycline,echocardiography,guidelines,her2 therapy,imaging

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