May 1, 2026European Heart Journal Supplements
Management of Heart Failure Therapy in Cancer Patients With Asymptomatic Cancer Treatment–related Cardiac Dysfunction (Ctrcd): The Match Survey Results
Key result
Only 3% of cardiologists discontinue HF therapy after LVEF recovery in asymptomatic CTRCD.
- n=250
Why the study?
Limited evidence is available on whether to stop or continue heart failure therapy after recovery of left ventricular function in asymptomatic cancer therapy-related cardiac dysfunction.
Key Points
- To evaluate real-world clinical decision-making regarding the continuation or discontinuation of heart failure therapy after left ventricular function recovery in patients with asymptomatic cancer therapy–related cardiac dysfunction.
- Survey administered to cardiologists during the 56th ANMCO National Congress in May 2025 across more than 2,000 contacts in Italy (N=250 complete responses analyzed).
- Assessed practice patterns regarding diagnostic monitoring modalities, heart failure pharmacological regimens, and protocols for therapy withdrawal following cardiac recovery.
- Two-dimensional echocardiography was the primary diagnostic tool for 85% of respondents, with angiotensin-converting enzyme inhibitors (31%), angiotensin receptor blockers (26%), and sodium-glucose cotransporter-2 inhibitors (14%) being the most commonly prescribed therapies.
- Only 3% of cardiologists discontinued heart failure therapy in more than 80% of patients after left ventricular ejection fraction recovery, typically waiting over 1 year post-recovery to attempt withdrawal.
- Discontinuation was primarily guided by 2022 ESC cardiovascular risk stratification, with 80% of clinicians recommending follow-up ejection fraction reassessment within 3 to 6 months after cessation.
Study Design
Type
Cross-Sectional (n=250)
Structured PICO
P
Population
250 Italian cardiologists surveyed on their management of heart failure therapy in cancer patients with asymptomatic cancer treatment-related cardiac dysfunction.
O
Outcome
Real-world approach to stopping or continuing heart failure therapy after recovery of left ventricular function
A survey of Italian cardiologists reveals that discontinuation of heart failure therapy after recovery from asymptomatic cancer treatment-related cardiac dysfunction is uncommon in real-world practice.
Implication
Most clinicians continue therapy post-LVEF recovery in asymptomatic CTRCD; leaves open optimal withdrawal strategies and need for prospective trials.
Abstract
Background Cardiovascular toxicity could potentially limit anticancer therapy and its features encompassed many different clinical scenarios. Among others, cancer therapy–related cardiac dysfunction (CTRCD) with left ventricular (LV) systolic impairment could represent a major issue. CTRCD is frequently asymptomatic and often effectively treated with standard heart failure (HF) therapy. Limited evidence is available on the need to stop or continue HF therapy after recovery of LV function. The MATCH survey aimed to investigate the real–world approach of Italian cardiologists to this clinical dilemma. Results The survey was conducted during the 56th ANMCO National Congress in May 2025. Among more than 2,000 contacts, 250 complete responses from cardiologists were analyzed. 52% of responders reported the lack of a dedicated cardio–oncology service despite managing a higher weekly volume of cancer patients compared with specialised centers (84 vs 29 patients/week) (Fig 1). Two–dimensional echocardiography (2D Echo) was the preferred diagnostic tool for CTRCD in 85% of cases, mainly based on LV ejection fraction (LVEF) assessment, whereas only 10% relied on biomarkers. Angiotensin–converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), and sodium–glucose cotransporter–2 inhibitors (SGLT2i) were the most frequently prescribed therapies (31%, 26%, and 14%, respectively) (Fig. 2). Only 3% of cardiologists reported discontinuing HF therapy after recovery of LVEF in over 80% of patients (Fig 3), usually ›1 year after recovery. Discontinuation was primarily guided by cardiovascular risk stratification according to the 2022 ESC Guidelines, and 80% recommended reassessment of LVEF 3–6 months after therapy withdrawal. Few patients required re–start of therapy due to recurrent systolic dysfunction, mainly those at high cardiovascular risk or undergoing further potentially cardiotoxic anticancer treatments. Conclusions In Italy, discontinuation of HF therapy after asymptomatic CTRCD is uncommon. Patients needs (as pregnancy planning) should be more and more taken into consideration in this challenging decision making. Prospective randomized studies are needed to define the optimal management of patients with stable recovery of LV function after asymptomatic CTRCD.
Eur Heart J Suppl · survey. Only 3% of Italian cardiologists stop HF therapy in most patients after CTRCD recovery Management of Heart Failure Therapy in Cancer Patients With Asymptomatic Cancer Treatment–related Cardiac Dysfunction (Ctrcd): The Match Survey Results Stop HF therapy once LVEF recovers in asymptomatic CTRCD? 250 cardiologists: Italian cardiologists answered the MATCH survey. Most prescribed HF therapies: ACE inhibitors 31%, ARBs 26%, SGLT2 inhibitors 14%. 85% of respondents: 2D echo is the primary diagnostic tool. How withdrawal is usually attempted: Wait over 1 year → 2022 ESC risk stratification → Stop HF therapy → Recheck EF in 3-6 months. Bottom line: Most continue HF therapy after recovery; withdrawal strategies need prospective trials.
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Cite This Study
Oliva et al. (2026) conducted a cross-sectional in Asymptomatic cancer treatment-related cardiac dysfunction (CTRCD) (n=250). Survey on heart failure therapy management was evaluated on Proportion of cardiologists discontinuing HF therapy after LVEF recovery. A survey of 250 Italian cardiologists revealed that only 3% discontinue heart failure therapy after recovery of left ventricular ejection fraction in patients with asymptomatic CTRCD.