The State of the Art in Cardio-Oncology

Dear Colleagues,

Cardio-oncology is undergoing a significant transformation. What began as a niche field primarily concerned with investigating and managing cardiotoxicity resulting from cancer therapies has, in recent years, evolved into a well-established subspecialty. The scope of cardio-oncology now encompasses not only the prevention of cardiotoxicity but also the management of both longstanding and emerging cardiovascular risk factors in cancer patients. It focuses on delivering optimal cardiac care, including interventional procedures when necessary, to this growing patient population.

A deeper understanding of the pathophysiological mechanisms behind various cardiotoxicities has given rise to a new area within the field, referred to as “reverse cardio-oncology.” Notably, cancer and cardiovascular diseases—the two leading causes of mortality in Western countries—have been found to share not only several risk factors but also certain underlying pathophysiological mechanisms. This bidirectional relationship underscores the importance of cardio-oncology for both cardiologists and oncologists, considering the vast number of patients affected.

Insights into the mechanisms of specific cardiotoxicities have also facilitated the identification of potential new therapeutic targets for heart diseases in patients without cancer. As advances in cancer treatments yield a growing population of long-term survivors, including those with metastatic disease, the need for comprehensive cardiovascular care becomes increasingly critical.

Central to the modern approach is the concept of “precision cardio-oncology,” which emphasizes tailoring patient management throughout the entire cancer journey—from initial diagnosis through treatment and long-term follow-up—based on individual patient and cancer characteristics. In addition, innovative imaging technologies such as computed tomography and cardiac magnetic resonance imaging, combined with the expanding use of artificial intelligence, are opening new avenues for research and clinical practice in cardio-oncology.

This Special Issue is dedicated to exploring the history, development, and future directions of cardio-oncology, highlighting its expanding role and the ongoing innovations shaping its trajectory.

Dr. Fabio Maria Turazza
Guest Editor

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