Heart Failure Seminar: Focus on HF and Chemotherapy (OnDemand)-Focus on Heart Failure: Focus on Chemotherapy Video

Video Transcription

Video Summary

The webinar, hosted by HFSA, focused on heart failure and chemotherapy-related cardiotoxicity, featuring three talks and a brief Q&A wrap-up.<br /><br />Dr. Jean Kim opened with a case-based review of immune checkpoint inhibitor (ICI)-associated myocarditis. She presented a patient with recent pembrolizumab exposure who developed chest pain, dyspnea, markedly elevated troponin, ST changes, and reduced ventricular function despite normal coronary angiography. Cardiac MRI met Lake Louise criteria for myocarditis. The case illustrated the need for immediate empiric high-dose IV steroids when ICI myocarditis is suspected, along with close telemetry monitoring and escalation to multimodal immunosuppression in fulminant or steroid-refractory cases. She also emphasized the risk of arrhythmias, conduction disease, and overlap with myositis/myasthenia (“2M/3M syndrome”).<br /><br />Dr. Diego Sadler discussed cancer therapy-related cardiac dysfunction, especially anthracyclines and HER2-targeted therapies. He reviewed risk stratification using tools such as HFA-ICOS, monitoring intensity based on risk, and cardioprotective options including dexrazoxane, liposomal anthracyclines, neurohormonal blockade, statins, and emerging data on SGLT2 inhibitors. He emphasized that anthracyclines have no truly safe dose, while HER2 therapy cardiotoxicity is often reversible and interruption should be avoided when possible. He also highlighted permissive cardiotoxicity in selected patients with mild asymptomatic LVEF decline.<br /><br />Dr. Aaron Bagnola expanded on prevention and management strategies. He reviewed the evidence for dexrazoxane as the only FDA-approved cardioprotective agent for anthracyclines and summarized mixed trial data for beta-blockers, ACE inhibitors/ARBs, MRAs, statins, and SGLT2 inhibitors. He stressed the importance of baseline cardiovascular risk assessment, controlling comorbidities, and tailoring prevention to patient risk.<br /><br />The session concluded without a panel discussion, with attendees directed to email questions and complete CE requirements through the HFSA Learning Center.

Keywords

heart failure

chemotherapy cardiotoxicity

immune checkpoint inhibitor myocarditis

pembrolizumab

cardiac MRI

anthracyclines

HER2-targeted therapy

dexrazoxane

cardioprotection

risk stratification