Table 2 Risk assessment and monitoring associated with left ventricular dysfunction
From: Rationale for setting up a cardio-oncology unit: our experience at Mayo Clinic
Patient-related risk factors | Medication-related risk factor a |
|---|---|
  1 point for each risk factor present |   High (risk score 4): Anthracyclines, Trastuzumab, Ifosfamide, Cyclophosphamide, Clofarabine |
  Age (bimodal distribution): <15 or > 65 years   Female   Hypertension   Diabetes Mellitus   Atherosclerosis (coronary artery disease, cerebrovascular disease, peripheral artery disease)   Preexisting heart disease or heart failure   Prior anthracycline   Prior radiation therapy to the chest |   Intermediate (risk score 2): Docetaxel, Pertuzumab, Sunitinib, Sorafenib |
  Low (risk score 1): Bevacizumab, Imatinib, Lapatinib, Dasatinib | |
  Rare (risk score 0): Etoposide, Rituximab, Thalidomide | |
Cardiotoxicity Risk Score (CRS)  Medication-related risk score + number of patient-related risk factors = CRS > 6: very high; CRS 5-6: high; CRS 3-4: intermediate; CRS 1-2: low; CRS 0: very low | |
Mayo Clinic monitoring recommendations | |
  Very high risk: Echocardiogram with GLS before every (other) cycle, end, 3-6 months and 1 year. Optional ECG, cTn with echocardiogram during chemotherapy | |
  High risk: Echocardiogram with GLS every 3 cycles, end, 3-6 months and 1 year after treatment. Optional ECG, cTn with echocardiogram during chemotherapy | |
  Intermediate risk: Echocardiogram with GLS, mid-term, end and 3-6 after treatment. Optional ECG, cTn mid-term of chemotherapy | |
  Low risk: Optional echocardiogram with GLS and/or ECG. cTn at the end of treatment | |
  Very low risk: None | |