BSE and BCOS Guideline for Transthoracic Echocardiographic Assessment of Adult Cancer Patients Receiving Anthracyclines and/or Trastuzumab

Dobson, Rebecca; Ghosh, Arjun K.; Ky, Bonnie; Marwick, Tom; Stout, Martin; Harkness, Allan; Steeds, Rick; Robinson, Shaun; Oxborough, David; Adlam, David; Stanway, Susannah; Rana, Bushra; Ingram, Thomas; Ring, Liam; Rosen, Stuart; Plummer, Chris; Manisty, Charlotte; Harbinson, Mark; Sharma, Vishal; Pearce, Keith; Lyon, Alexander R.; Augustine, Daniel X.

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 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.