Cardiovascular side effects of cancer therapies: a position statement from the Heart Failure Association of the European Society of Cardiology

Thomas Eschenhagen*, Thomas Force, Michael S. Ewer, Gilles W. De Keulenaer, Thomas M. Suter, Stefan D. Anker, Metin Avkiran, Evandro de Azambuja, Jean Luc Balligand, Dirk L. Brutsaert, Gianluigi Condorelli, Arne Hansen, Stephane Heymans, Joseph A. Hill, Emilio Hirsch, Denise Hilfiker-Kleiner, Stefan Janssens, Steven de Jong, Gitte Neubauer, Burkert PieskePiotr Ponikowski, Munir Pirmohamed, Mathias Rauchhaus, Douglas Sawyer, Peter H. Sugden, Johann Wojta, Faiez Zannad, Ajay M. Shah

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


pre-clinicalreductions in mortality and morbidity being achieved among cancer patients with current therapies represent a major achievement. However, given their mechanisms of action, many anti-cancer agents may have significant potential for cardiovascular side effects, including the induction of heart failure. The magnitude of this problem remains unclear and is not readily apparent from current clinical trials of emerging targeted agents, which generally under-represent older patients and those with significant co-morbidities. The risk of adverse events may also increase when novel agents, which frequently modulate survival pathways, are used in combination with each other or with other conventional cytotoxic chemotherapeutics. The extent to which survival and growth pathways in the tumour cell (which we seek to inhibit) coincide with those in cardiovascular cells (which we seek to preserve) is an open question but one that will become ever more important with the development of new cancer therapies that target intracellular signalling pathways. It remains unclear whether potential cardiovascular problems can be predicted from analyses of such basic signalling mechanisms and what pre-clinical evaluation should be undertaken. The screening of patients, optimization of therapeutic schemes, monitoring of cardiovascular function during treatment, and the management of cardiovascular side effects are likely to become increasingly important in cancer patients. This paper summarizes the deliberations of a cross-disciplinary workshop organized by the Heart Failure Association of the European Society of Cardiology (held in Brussels in May 2009), which brought together clinicians working in cardiology and oncology and those involved in basic, translational, and pharmaceutical science.
Original languageEnglish
Pages (from-to)1-10
JournalEuropean journal of heart failure
Issue number1
Publication statusPublished - Jan 2011


  • Cardiotoxicity
  • Cardio-oncology
  • Targeted therapy
  • Anthracyclines
  • Heart failure
  • Consensus statement

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