{"id":1431,"date":"2026-04-29T13:11:31","date_gmt":"2026-04-29T11:11:31","guid":{"rendered":"https:\/\/bcco.abako.be\/?page_id=1431"},"modified":"2026-04-29T13:55:11","modified_gmt":"2026-04-29T11:55:11","slug":"basic-cv-risk-assessment","status":"publish","type":"page","link":"https:\/\/bcco.abako.be\/en\/hematologists\/basic-cv-risk-assessment\/","title":{"rendered":"Basic CV risk assessment"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1431\" class=\"elementor elementor-1431\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d6dffb1 e-flex e-con-boxed e-con e-parent\" data-id=\"d6dffb1\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-715487a e-con-full e-flex e-con e-child\" data-id=\"715487a\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-d65e514 e-con-full e-flex e-con e-child\" data-id=\"d65e514\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-98ede81 elementor-widget elementor-widget-text-editor\" data-id=\"98ede81\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><a href=\"https:\/\/bcco.abako.be\/en\/hematologists\/\">&lt;- Back to Hematologists<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c24907b elementor-widget elementor-widget-heading\" data-id=\"c24907b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Info<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-73f3d3e elementor-widget elementor-widget-heading\" data-id=\"73f3d3e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">For Hematologists<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9720744 elementor-widget elementor-widget-text-editor\" data-id=\"9720744\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The ESC Cardio-Oncology Guidelines emphasize that CV risk prevention should start at the time of cancer diagnosis and before initiation of therapy. This allows:<\/p><ul><li>identification of pre-existing CV disease and risk factors; (SCORE2 and SCORE2-OP)<\/li><li>estimation of cardiotoxicity risk related to the planned cancer therapy;<\/li><li>timely optimization of modifiable risk factors;<\/li><li>referral to cardio-oncology services for high-risk patients.<\/li><\/ul><p>CTR-CVT risk is dynamic \u2014 it can evolve throughout cancer therapy and survivorship. Regular reassessment is recommended.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-23355bf e-con-full e-flex e-con e-child\" data-id=\"23355bf\" data-element_type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0874bf4 e-flex e-con-boxed e-con e-parent\" data-id=\"0874bf4\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-f20022c e-con-full e-flex e-con e-child\" data-id=\"f20022c\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-e633d7f e-con-full e-flex e-con e-child\" data-id=\"e633d7f\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-b0675a6 e-con-full e-flex e-con e-child\" data-id=\"b0675a6\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-dd76ce1 e-con-full e-flex e-con e-child\" data-id=\"dd76ce1\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1e4e2a1 elementor-widget elementor-widget-heading\" data-id=\"1e4e2a1\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Baseline Cardiovascular Toxicity Risk Assessment\u200b<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1a659eb e-con-full e-flex e-con e-child\" data-id=\"1a659eb\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cfc95c5 elementor-widget elementor-widget-text-editor\" data-id=\"cfc95c5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>A systematic and personalized baseline assessment is mandatory before potentially cardiotoxic therapy.<br \/>The process integrates medical history, physical exam, laboratory evaluation, imaging, and structured risk scoring.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-fe492a2 e-flex e-con-boxed e-con e-parent\" data-id=\"fe492a2\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-80d42f8 e-con-full e-flex e-con e-child\" data-id=\"80d42f8\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d72465a elementor-widget elementor-widget-heading\" data-id=\"d72465a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">General Approach<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-424d5e2 e-con-full e-flex e-con e-child\" data-id=\"424d5e2\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-50e0042 elementor-widget elementor-widget-heading\" data-id=\"50e0042\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Checklist for baseline assessment:<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5daaa39 elementor-widget elementor-widget-text-editor\" data-id=\"5daaa39\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\u00a0<\/p><table><thead><tr><td><strong>Category<\/strong><\/td><td><strong>Components<\/strong><\/td><\/tr><\/thead><tbody><tr><td><strong>Medical history<\/strong><\/td><td><ul><li>Pre-existing cardiovascular disease (CVD)<\/li><li>Prior cardiotoxic cancer therapies<\/li><li>Traditional CV risk factors:<\/li><\/ul><p>hypertension, diabetes, dyslipidemia, smoking, obesity, sedentary lifestyle, alcohol use<\/p><\/td><\/tr><tr><td><strong>Physical examination<\/strong><\/td><td><ul><li>Vital signs<\/li><li>Blood pressure<\/li><li>Heart rate<\/li><\/ul><\/td><\/tr><tr><td><strong>Laboratory tests<\/strong><\/td><td><ul><li>Lipid profile<\/li><li>Fasting glucose, HbA1c<\/li><li>Kidney function (eGFR)<\/li><li>\u00b1 Cardiac biomarkers (hs-troponin, BNP\/NT-proBNP) depending on risk and treatment plan.<\/li><\/ul><p><em>Of note: NTproBNP is not reimbursed in Belgium<\/em><\/p><\/td><\/tr><tr><td><strong>ECG<\/strong><\/td><td><ul><li>Recommended for all patients<\/li><li>Assessment of rhythm, QTc, conduction abnormalities<\/li><\/ul><\/td><\/tr><tr><td><strong>Transthoracic echocardiography (TTE)<\/strong><\/td><td><ul><li>A complete TTE exam is mandatory, including<\/li><li>LVEF and GLS measurements<\/li><\/ul><p><em>if available, consider 3D LVEF) <\/em><\/p><\/td><\/tr><tr><td><strong>Other imaging<\/strong><\/td><td><ul><li>Cardiac MRI if echocardiography is non-diagnostic<\/li><\/ul><\/td><\/tr><tr><td><strong>Functional assessment<\/strong><\/td><td><ul><li>Optional cardiopulmonary exercise testing (CPET) in selected preoperative or high-risk cases<\/li><\/ul><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3e43939 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"3e43939\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download baseline<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5fbcd67 e-flex e-con-boxed e-con e-parent\" data-id=\"5fbcd67\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-cb10add e-con-full e-flex e-con e-child\" data-id=\"cb10add\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-7ba9b4d e-con-full e-flex e-con e-child\" data-id=\"7ba9b4d\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3030ae9 elementor-widget elementor-widget-text-editor\" data-id=\"3030ae9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Assess global CV risk using SCORE2 or SCORE2-OP for 10-year fatal and non-fatal CV risk. \u00a0\u00a0\u00a0\u00a0 <br \/>\u279c (<a href=\"https:\/\/www.heartscore.org\/en_GB?_gl=1*1om4e2l*_gcl_au*ODAxODcwOTQ3LjE3NTYzMjcyNDE.*_ga*MjkyODE1MTM5LjE2NzY0OTg1NTM.*_ga_VPF4X3T28K*czE3NTcyNjkyMjgkbzExOSRnMSR0MTc1NzI2OTc2OCRqNjAkbDAkaDA.*_ga_5Y189L6T14*czE3NTcyNjkyMjgkbzEzNCRnMSR0MTc1NzI2OTc2OCRqNjAkbDAkaDA.\" target=\"_blank\" rel=\"noopener\">HeartScore<\/a><u> ;<\/u> for Belgium:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <a href=\"https:\/\/heartscore.escardio.org\/Calculate\/quickcalculator.aspx?model=low\" target=\"_blank\" rel=\"noopener\">https:\/\/heartscore.escardio.org\/Calculate\/quickcalculator.aspx?model=low<\/a>)\u00a0\u00a0<\/li><li>Perform baseline risk stratification using the Heart Failure Association\u2013International Cardio-Oncology Society (HFA\u2013ICOS) risk tool. <br \/>\u279c <a href=\"https:\/\/www.cancercalc.com\/hfa-icos_cardio_oncology_risk_assessment.php\" target=\"_blank\" rel=\"noopener\">CancerCalc \u2013 HFA\u2013ICOS Risk Calculator<\/a><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-96f1c83 e-con-full e-flex e-con e-child\" data-id=\"96f1c83\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-930a0a8 e-con-full e-flex e-con e-child\" data-id=\"930a0a8\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-6ff5634 e-con-full e-flex e-con e-child\" data-id=\"6ff5634\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1bc96bd elementor-widget elementor-widget-heading\" data-id=\"1bc96bd\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Risk stratification\u200b<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8d7b90d e-flex e-con-boxed e-con e-parent\" data-id=\"8d7b90d\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-bdecfaf e-con-full e-flex e-con e-child\" data-id=\"bdecfaf\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8b375a3 elementor-widget elementor-widget-heading\" data-id=\"8b375a3\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Cardiology or Cardio-oncology Referral<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0161c75 e-con-full e-flex e-con e-child\" data-id=\"0161c75\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-63a0ee2 e-con-full e-flex e-con e-child\" data-id=\"63a0ee2\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fd0e295 elementor-widget elementor-widget-heading\" data-id=\"fd0e295\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Cardio-oncology referral in all patients with (moderate (Class IIb) to) high\/very high (Class I) risk before anti-cancer therapy:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2dd3dae elementor-widget elementor-widget-text-editor\" data-id=\"2dd3dae\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Age &gt;65 years<\/p><p>Multiple uncontrolled cardiovascular risk factors<\/p><p>Preexisting heart disease<\/p><p>Uncontrolled arterial hypertension<\/p><p>Any abnormal findings on the baseline TTE or ECG<\/p><p>High or very high risk for cardiotoxicity based on Cardio-Oncology Society (HFA\u2013ICOS) risk calculator (<a href=\"https:\/\/www.cancercalc.com\/hfa-icos_cardio_oncology_risk_assessment.php\" target=\"_blank\" rel=\"noopener\">CancerCalc \u2013 HFA\u2013ICOS Risk Calculator<\/a>)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2647646 e-con-full e-flex e-con e-child\" data-id=\"2647646\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fdb44c0 elementor-widget elementor-widget-heading\" data-id=\"fdb44c0\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">During treatment cardio-oncology referral, if: <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d83a39f elementor-widget elementor-widget-text-editor\" data-id=\"d83a39f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Decrease of LVEF by 10% from the baseline, or new LVEF reduction to &lt;50%<\/p><p>Decrease of GLS &gt;15% from the baseline<\/p><p>Development of uncontrolled arterial hypertension<\/p><p>Development of atrial fibrillation or other arrhythmias<\/p><p>New cardiovascular signs and symptoms<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-efed161 e-con-full e-flex e-con e-child\" data-id=\"efed161\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ba9e0f3 elementor-align-left elementor-widget elementor-widget-button\" data-id=\"ba9e0f3\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">General approach<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-56b17ad elementor-align-left elementor-widget elementor-widget-button\" data-id=\"56b17ad\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Pathways<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>&lt;- Back to Hematologists Info For Hematologists The ESC Cardio-Oncology Guidelines emphasize that CV risk prevention should start at the time of cancer diagnosis and before initiation of therapy. This allows: identification of pre-existing CV disease and risk factors; (SCORE2 and SCORE2-OP) estimation of cardiotoxicity risk related to the planned cancer therapy; timely optimization of [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":429,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1431","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Basic CV risk assessment - Belgian Council on Cardio-Oncology<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Basic CV risk assessment - Belgian Council on Cardio-Oncology\" \/>\n<meta property=\"og:description\" content=\"&lt;- Back to Hematologists Info For Hematologists The ESC Cardio-Oncology Guidelines emphasize that CV risk prevention should start at the time of cancer diagnosis and before initiation of therapy. 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