ONCOR: design of the Dutch cardio-oncology registry.

BACKGROUND: The relative new subspecialty 'cardio-oncology' was established to meet the growing demand for an interdisciplinary approach to the management of cancer therapy-related cardiovascular adverse events. In recent years, specialised cardio-oncology services have been implemented worldwide, which all strive to improve the cardiovascular health of cancer patients. However, limited data are currently available on the outcomes and experiences of these specialised services, and optimal strategies for cardio-oncological care have not been established. AIM: The ONCOR registry has been created for prospective data collection and evaluation of cardio-oncological care in daily practice. METHODS: Dutch hospitals using a standardised cardio-oncology care pathway are included in this national, multicentre, observational cohort study. All patients visiting these cardio-oncology services are eligible for study inclusion. Data collection at baseline consists of the (planned) cancer treatment and the cardiovascular risk profile, which are used to estimate the cardiotoxic risk. Information regarding invasive and noninvasive tests is collected during the time patients receive cardio-oncological care. Outcome data consist of the incidence of cardiovascular complications and major adverse cardiac events, and the impact of these events on the oncological treatment. DISCUSSION: Outcomes of the ONCOR registry may aid in gaining more insight into the incidence of cancer therapy-related cardiovascular complications. The registry facilitates research on mechanisms of cardiovascular complications and on diagnostic, prognostic and therapeutic strategies. In addition, it provides a platform for future (interventional) studies. Centres with cardio-oncology services that are interested in contributing to the ONCOR registry are hereby invited to participate.

[Takotsubo cardiomyopathy as a complication of electroconvulsive therapy]. / Takotsubo-cardiomyopathie als complicatie van elektroconvulsietherapie.

Takotsubo cardiomyopathy is an acute, stress-induced, reversible cardiac syndrome and can occur as a rare complication in electroconvulsive therapy. We give further details of this complication by referring to the case of a 67-year-old female patient. In addition, we give a brief description of the background of the syndrome. If this syndrome is suspected, the patient should immediately be referred for cardiac diagnostic tests to rule out myocardial infarction. There is no absolute contra-indication to ECT for a patient who has experienced Takotsubo cardiomyopathy. However, to start ECT treatment again it is recommended that this should be performed in a general hospital and in combination with beta-blockers.