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Cancer diagnosis in patients with heart failure: epidemiology,clinical implications and gaps in knowledge

Authors:	Pietro Ameri Marco Canepa Markus S. Anker Yury Belenkov Jutta Bergler‐Klein Alain Cohen‐Solal Dimitrios Farmakis Teresa López‐Fernández Mitja Lainscak Radek Pudil Frank Ruschitska Petar Seferovic Gerasimos Filippatos Andrew Coats Thomas Suter Stephan Von Haehling Fortunato Ciardiello Rudolf A. de Boer Alexander R. Lyon Carlo G. Tocchetti for the Heart Failure Association Cardio‐Oncology Study Group of the European Society of Cardiology

Affiliation:	1. Department of Internal Medicine, University of Genova;2. and Cardiology Unit, IRCCS Policlinic Hospital San Martino, Genova, Italy;3. Department of Cardiology (CBF), Charité University Medicine, Berlin, Germany;4. AND Division of Cardiology and Metabolism ‐ Heart Failure, Cachexia & Sarcopenia;5. Department of Internal Medicine & Cardiology;6. and Berlin‐Brandenburg Center for Regenerative Therapies (BCRT), at Charité University Medicine, Berlin, Germany;7. Cardiology Research Institute, Moscow, Russia;8. Department of Cardiology, Medical University of Vienna, Vienna, Austria;9. Department of Cardiology, Lariboisière Hospital, Paris, France;10. U942 INSERM, BIOCANVAS (Biomarqueurs Cardiovasculaires), Paris, France;11. , Department of Cardiology, University of Paris VII Denis Diderot, Paris, France;12. Cardio‐Oncology Clinic, Heart Failure Unit, Department of Cardiology, Athens University Hospital ‘Attikon’, National and Kapodistrian University of Athens, Athens, Greece;13. Cardio‐Oncology Unit, Cardiac Imaging Unit, Department of Cardiology, La Paz University Hospital, IdiPAz, Madrid, Spain;14. Department of Cardiology, Department of Research and Education, General Hospital Celje, Celje, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia;15. 1st Department of Medicine ‐ Cardioangiology, Medical Faculty and University Hospital Hradec Kralove, Czech Republic;16. University Heart Center, University Hospital Zurich, Zurich, Switzerland;17. Belgrade University Medical Center, Belgrade, Serbia;18. Monash University, Australia and University of Warwick, UK;19. Department of Cardiology, Cardio‐Oncology, Bern University Hospital, Bern, Switzerland;20. Klinik für Kardiologie und Pneumologie, Herzzentrum G?ttingen, Universit?tsmedizin G?ttingen, Georg‐August‐Universit?t, G?ttingen, Germany;21. , Deutsches Zentrum für Herz‐ und Kreislaufforschung, Standort G?ttingen, G?ttingen, Germany;22. Department of Clinical and Experimental Medicine “Flaviano Magrassi”, Luigi Vanvitelli University of Campania, Naples, Italy;23. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;24. Royal Brompton Hospital and Imperial College London, UK;25. Department of Translational Medical Sciences, Federico II University, Naples, Italy

Abstract:	Cancer and heart failure (HF) are common medical conditions with a steadily rising prevalence in industrialized countries, particularly in the elderly, and they both potentially carry a poor prognosis. A new diagnosis of malignancy in subjects with pre‐existing HF is not infrequent, and challenges HF specialists as well as oncologists with complex questions relating to both HF and cancer management. An increased incidence of cancer in patients with established HF has also been suggested. This review paper summarizes the epidemiology and the prognostic implications of cancer occurrence in HF, the impact of pre‐existing HF on cancer treatment decisions and the impact of cancer on HF therapeutic options, while providing some practical suggestions regarding patient care and highlighting gaps in knowledge.

Keywords:	Heart failure Cancer Therapy Prognosis Co‐morbidity

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