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Advanced Therapies for Chemotherapy-Induced Heart Failure: Understanding and Treatment

Learn about advanced heart failure therapies for chemotherapy-induced cardiomyopathy with a focus on distinguishing characteristics, right ventricular involvement, and use of LVADs. Explore the prevalence, prognosis, and survival rates for CCMP patients.

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Advanced Therapies for Chemotherapy-Induced Heart Failure: Understanding and Treatment

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  1. Advanced Heart Failure Therapies for Chemotherapy-Induced Cardiomyopathy Dr. Varun Sundaram MD On behalf of Dr. Guilherme H Oliveira, MD Associate Professor of Medicine Chief, Section of Heart Failure & Cardiac Transplantation Director, UH Seidman Onco-Cardiology ProgramHarrington Heart & Vascular Institute University Hospitals Case Medical Center Case Western Reserve University

  2. Scope of the problem Distinguishing characteristics of CCMP patients with advanced heart failure in the waiting list Right ventricular involvement in CCMP LVADS in CCMP Outline 2

  3. Number of Cancer Survivors in the US 1 in 23 Americans is a cancer Survivor today AACR Cancer Progress Report 2013 3

  4. Prevalence of CCMP within Advanced Heart Failure Population 1000-5000 patients with CCMP 1. Miller LW et al. J Am Coll Cardiol Vol. 61,2013 2. Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014 3. Oliveira GH et al. J Heart Lung Transplant, 2012 4. Oliveira GH et al. Circ Heart Fail, Vol 7 (8), 2014

  5. Incidence of heart transplant for CCMP Unpublished data

  6. Malignancies associated with CCMP and advanced HF Oliveira GH et al. J Heart Lung Transplant, 2012

  7. Prognosis of CCMP Felker et al. NEJM 2000

  8. Scope of the problem Distinguishing characteristics of CCMP patients with advanced heart failure Right ventricular involvement in CCMP LVADS in CCMP Outline 8

  9. Baseline Characteristics (p=0.05) Oliveira GH et al. JHLT 2012

  10. Different sizes between CCMP and NICMP Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  11. Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  12. Natural History of CCMP Unpublished data

  13. Women are at higher risk for wait-list mortality or deterioration Adjusted for UNOS Status and year of listing Unpublished data * Adjusted for UNOS Status and year of listing * Adjusted for UNOS Status and year of listing

  14. Unpublished data

  15. Unpublished data

  16. Scope of the problem Distinguishing characteristics of CCMP patients with advanced heart failure in the waiting list Right ventricular involvement in CCMP LVADS in CCMP Outline 16

  17. The RV in CCMP Oliveira GH et al. J Heart Lung Transplant, 2012

  18. Oliveira GH et al. Circ Heart Fail, Vol 8, 2014 18

  19. Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  20. Scope of the problem Distinguishing characteristics of CCMP patients with advanced heart failure in the waiting list Right ventricular involvement in CCMP LVADS in CCMP Outline 20

  21. Oliveira GH et al. Circ Heart Fail, Vol 8, 2014

  22. Survival of CCMP with LVADS

  23. LVAD survival: CCMP vs. others Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  24. CCMP with BiVADS Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  25. Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  26. Oliveira GH et al. J Am Coll Cardiol Vol 62, 2014

  27. Incidence of patients with advanced heart failure from cancer therapies is increasing • Most common malignancies associated with CCMP are breast cancer and hematologic malignancies • CCMP is associated with more RV involvement than most other types of cardiomyopathies • Patients with CCMP that require advanced heart failure therapies are predominantly female CONCLUSIONS

  28. CONCLUSIONS • LVADs are safe and effective in CCMP patients and survival • is the same unless RVAD is needed

  29. Thank you!

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