Background: The right ventricle (RV) remains the 'forgotten chamber' in the clinical assessment of cancer therapy-related cardiac dysfunction (CTRCD). Aim: We aimed to review the role that various cardiac imaging modalities play in RV assessment as part of the integrative management of patients undergoing cancer therapy. Discussion: RV assessment remains challenging by traditional 2D echocardiography. In this review we discuss other parameters such as right atrial strain, and other echocardiographic modalities such as 3D and stress echocardiography. We also elaborate on the specific role that cardiac magnetic resonance imaging and equilibrium radionuclide angiocardiography can play in assessing the RV. Conclusion: Biventricular function should be monitored following chemotherapy for early detection of subclinical CTRCD and possible solitary RV changes.
Keywords: anthracycline; cancer treatment; cardio-oncology; cardiotoxicity; echocardiography; equilibrium radionuclide angiocardiography; magnetic resonance imaging; right ventricle; trastuzumab.
Cancer is among the most common health concerns worldwide. In addition to cancer's effects itself on the body, chemotherapy agents and medication, drug treatments that use powerful chemicals to kill cancer cells, are putting further strain on individuals' bodies impairing their quality of life. Chemotherapy agents are a major risk factor for cardiac injuries by their cardiotoxic effects (the damage they cause to the heart). Previous studies have tried to find the earliest way of noticing cardiac changes in patients who are receiving special chemotherapy drugs. Most of the studies and definitions for this cardiotoxic event are limited to the assessment of left ventricles, one of the chambers of the heart that is involved in providing oxygenated blood to the body. However, there is some evidence that suggests the evaluation of the right ventricle, another chamber of the heart that pumps blood low in oxygen to the lungs, for faster notice. Having this insight can open new targets for cancer therapy-related cardiac dysfunction (CTRCD) prevention and therapy.