The Utility of Cardiac Biomarkers, Tissue Velocity and Strain Rate Imaging for the Early Detection of Bevacizumab and Sunitinib Mediated Cardiotoxicity

Cardiovascular disease and cancer are major public health concerns in Canada. Although the current combination of surgical resection, radiation, and drug therapy may lead to a cure in cancer patients, the recent introduction of novel targeted therapeutics, including monoclonal antibodies [Bevacizumab (BVZ)] and tyrosine kinase inhibitors [Sunitinib (SNT)] is associated with an increased risk of cardiotoxicity. Serial monitoring of left ventricular ejection fraction (LVEF) using cardiac imaging is the single most important clinical diagnostic tool in the recognition of cardiac dysfunction in cancer patients. In the emerging field of Cardio-Oncology, early indices of left ventricular (LV) systolic dysfunction would be useful for addressing the cardiac safety profile of cancer drugs, potentially avoiding the detrimental side effects of end stage heart failure.