Type II Chemotherapy-Related Cardiac Dysfunction: Time to Recognize a New Entity

Cancer chemotherapy can affect the heart in a variety of ways. Fluorouracil and capecitabine may initiate coronary artery spasm, high-dose cyclophosphamide can induce a hemorrhagic myonecrosis, and paclitaxel is associated with dysrhythmia. However, the form of chemotherapyrelated cardiac dysfunction (CRCD) of the greatest interest and concern among oncologists and cardiologists is that which directly involves the myocardium, is manifested by a decreased left-ventricular ejection fraction, and which may progress to congestive heart failure; this form is the focus of our brief commentary. CRCD came to the forefront of concerns over chemotherapy in the early 1970s, when anthracyclines were shown to exhibit…