Table 1.

Concordances and discordances among cardiomyopathy surveillance recommendations

Who needs cardiomyopathy surveillance?
At risk
Anthracyclines	Yes	Yes	Yes	Yes	Concordance
Mitoxantrone	Yes	Yes	Yes	Yes	Concordance
Differing risk by anthracycline analogues	Yes	Not stated	Not stated	Not stated	Discordance
Chest Radiation*	Yes	Yes	Yes	Yes	Concordance
CV risk factors	Yes	Yes	Yes	Yes	Concordance
Highest risk	≥300 mg/m2 anthracyclines ≥30 Gy RT involving heart Anthracyclines + chest RT Younger age at treatment Pregnancy	≥300 mg/m2 anthracyclines ≥30 Gy RT involving heart Anthracyclines + chest RT Pregnancy	>250 mg/m2 anthracyclines Anthracyclines + chest RT Hx of transient cardiomyopathy during treatment Pregnancy	>250 mg/m2 anthracyclines ≥30 Gy RT involving heart Anthracyclines + chest RT	Discordance
What surveillance modality should be used?
Screening for cardiomyopathy
Echocardiography	Yes	Yes	Yes	Yes	Concordance
Radionuclide angiography	Yes	Yes	No	No	Discordance
At what frequency and for how long should cardiomyopathy surveillance be performed?
Screening begins	≥2 yrs after treatment or ≥5 yrs after dx (whichever is first)	≥5 yrs after diagnosis	1–3 months after treatment	≥5 yrs after completion of treatment	Discordance
Screening frequency	Every 1 –5 yrs	Every 2–5 years	Every 3–5 yrs	Every 2–5 yrs	Discordance
Duration of screening	Lifelong	Lifelong	Not stated	Not stated	Discordance
Closer monitoring during pregnancy	Yes	Yes	Yes	Yes	Concordance
Refer to cardiologist	Yes	Yes	Yes	Yes	Concordance
Consider ACE-inhibitors	Not stated	Yes	Not stated	Yes	Discordance

^*Radiation therapy (RT) involving the heart: mediastinal, thoracic, spinal, left or whole upper abdominal or total body irradiation (TBI)

Abbreviations: Hx, History; CV, cardiovascular; Gy, Gray; yrs, years; ACE, angiotensin converting enzyme; Dx, diagnosis.