Modern strategies for early diagnosis of cardiotoxicity caused by chemotherapy

Cardiotoxicity due to antitumor chemotherapy and targeted therapy is a severe complication that reduces the effectiveness of treatment and worsens the prognosis in patients with malignancies. Therefore, early diagnosis of myocardial injury is particularly relevant, allowing for a timely adjustment of the therapeutic approach. Objective. To evaluate current cardiovascular imaging and monitoring techniques used for early detection of cardiotoxicity. Materials and methods. The review methodology involved searching and analyzing scientific data from Russian and international publications, selected by keywords and topics, in the PubMed, Scopus, Web of Science, and eLibrary databases for the period from 2015 to 2025, considering relevance and scientific significance criteria. Results. Two-dimensional and three-dimensional echocardiography capabilities are presented, including evaluation of global longitudinal myocardial strain as a sensitive marker of early systolic dysfunction. The diagnostic advantages of magnetic resonance imaging (MRI) of the heart, which provides an accurate quantitative assessment of myocardial morphology and tissue characteristics, are highlighted. Radioisotope methods, including scintigraphy and positron emission tomography, are considered to assess perfusion, metabolism, and cellular damage. The advantages of using myocardial damage biomarkers to detect cardiotoxicity in the early stages were analyzed. Conclusion. The integration of these methods into clinical practice contributes to personalized monitoring, increased safety of anticancer treatment, and a reduced risk of cardiovascular complications.