Table 2.

Cardiovascular monitoring of cancer patients^*

Approach	Before antineoplastic therapy†	During antineoplastic therapy‡ and follow-up
Clinical assessment	Familial and personal anamnesis; physical examination; diagnosis; risk assessment (5); (www.acc.org/qualityandscience/clinical/statements.htm)	Physical examination; cancer therapy evaluation (ctep.info.nih.gov); risk reassessment (5); (www.acc.org/qualityandscience/clinical/statements.htm)
Tests	Blood pressure assessment; chest radiography; LVEF evaluation by any of these means: ECG, dynamic ECG, Eco-Doppler, MUGA scanning (5,11)	Blood pressure assessment; chest radiography; LVEF follow-up by any of these means: ECG, dynamic ECG, Eco-Doppler, MUGA scanning (5,11)
Serum markers	Troponin isoforms; B-type natriuretic peptide; myeloperoxidase (5,70–72)	Troponin isoforms; B-type natriuretic peptide myeloperoxidase (5,70–72)
Prevention-Treatment	Lifestyle adjustments; cardioprotection; ACE inhibitors; angiotensin II receptor blockers; β-blockers; prevention of thromboembolism with aspirin or anticoagulants or platelet antiaggregants (5,63); (www.acc.org/qualityandscience/clinical/statements.htm)	ACE inhibitors; angiotensin II receptor blockers; β-blockers; cardiologic therapeutic regimen titration; other appropriate therapies (ie, anticoagulant therapies); change of antineoplastic therapeutic regimen (drug, schedule, or suspension) (5,47); (www.acc.org/qualityandscience/clinical/statements.htm)

^*ACE = angiotensin-converting enzyme; ECG = electrocardiogram; LVEF = left ventricular ejection fraction; MUGA = multiple gated acquisition.

^†In our approach, we propose to perform a preliminary evaluation 10 days before beginning of the antineoplastic therapy. Different schedules can be followed (3,73).

^‡In the proposed protocol, we suggest a cardiovascular evaluation at 2 and 4 weeks after the beginning of the antineoplastic therapy, followed by physical and instrumental evaluation every 6 weeks throughout the course of the treatment, different schedules can be followed (3,73). In our approach, physical and instrumental evaluation could be set after 3, 6, 12, 18, and 24 months after ending antineoplastic therapy. Schedule may change depending on the clinician's judgment, different schedules can be followed (3,73).