Cardiac Magnetic Resonance and Cardio-Oncology

A nthracycline-based chemotherapy has played an important role in cancer care since the 1960s, either as a single agent or in combination with other chemotherapeutics, to treat a broad range of hematological and solid tumor malignancies in children and adults. Anthracyclines, however, are associated with an increased risk of cardiotoxicity, manifest by left ventricular dysfunction and/or heart failure (1). Anthracycline cardiotoxicity is at least in part mediated through the formation of reactive oxygen species, leading to oxidative stress and mitochondrial dysfunction (2). Anthracyclines bind to cardiomyocyte-specific topoisomerase-IIb and cause DNA double strand breaks and transcriptome changes that are responsible for regulation of mitochondrial bioenergetics, generation of reactive oxygen species, and oxidative phosphorylation (3). Risk stratification and early detection of anthracycline cardiotoxicity are 2 important aspects of cardio-oncology care, as they provide an opportunity to initiate cardioprotective strategies and ultimately mitigate the risk of myocardial injury and heart failure. Major risk factors for anthracycline cardiotoxicity include high cumulative anthracycline dose, age, radiation exposure to the heart, and concomitant treatment with other cardiotoxic therapies, such