EACVI 2025 Study Finds Severe Valve Disease Raises Mortality Risk in Cancer Patients but Treatment Markedly Improves Outcomes

EACVI 2025 strengthens multi-modality imaging expertise with advanced training, guideline updates and AI-driven insights

(IN BRIEF) A major observational study presented at EACVI 2025 found that valvular heart disease is common in patients with prior cancer diagnoses, with 7.2% showing severe disease on echocardiography. Conditions such as tricuspid and mitral regurgitation and aortic stenosis were independent predictors of mortality and cardiovascular death. Only about one in five patients with severe disease underwent an intervention, but those who did experienced a 72% reduction in mortality after a median follow-up of nearly two years. Study investigator Dr. Maximilian Autherith emphasized the growing relevance of cardiovascular complications in cancer survivors and highlighted the need for regular imaging and assessment to guide patient management. The findings also suggest that interventional treatment can provide substantial benefit and should not be withheld solely due to a cancer history. The research aligns with current ESC cardio-oncology guidance, which calls for enhanced monitoring and integrated care for cancer survivors at risk of cardiovascular disease.

(PRESS RELEASE) VIENNA, 11-Dec-2025 — /EuropaWire/ — New research presented at EACVI 2025, the flagship congress of the European Association of Cardiovascular Imaging (EACVI), reveals that valvular heart disease is widespread among patients with a history of cancer, yet only a small proportion receive interventional treatment. When these interventions are performed, however, they are associated with striking survival benefits, underscoring the need for systematic cardiovascular monitoring in oncology care.

Advances in cancer therapy have significantly extended survival, but they have also brought increased awareness of long-term cardiovascular risks. Many cancer treatments—such as anthracycline chemotherapy—are known to cause cardiotoxicity, potentially contributing to conditions such as mitral and tricuspid regurgitation. As cancer survivors live longer, the management of concomitant cardiovascular disease has become an increasingly important clinical challenge.

These issues motivated the CESAR study, a retrospective observational analysis examining the prevalence, severity, and clinical consequences of valvular heart disease in patients with a confirmed cancer diagnosis.

High burden of valvular disease and strong survival impact

The study evaluated 10,353 adults who underwent transthoracic echocardiography within 12 months of cancer diagnosis at a tertiary referral centre. The average age was 66.2 years, and nearly half of the cohort were women.

Researchers found that 7.2% of patients had severe valvular heart disease—most frequently:

• Tricuspid regurgitation (3.7%)

• Mitral regurgitation (2.6%)

• Aortic stenosis (2.2%)

After adjusting for age, sex, biomarkers, kidney function, and left ventricular performance, severe valvular heart disease was confirmed as an independent predictor of mortality (adjusted HR 1.46; 95% CI 1.25–1.71) and cardiovascular death (adjusted HR 2.62; 95% CI 2.00–3.43).

Despite the high prevalence, only 21.5% of patients with severe disease underwent a surgical or transcatheter intervention. Those who did receive an intervention showed a dramatic 72% mortality reduction (adjusted HR 0.28; 95% CI 0.09–0.87) over a median follow-up of 23 months.

Expert perspective

Presenting the findings, Doctor Maximilian Autherith of the Medical University of Vienna commented:
“Severe valvular heart disease was common in this cohort of cancer patients undergoing echocardiography. Although relatively few underwent interventions, those who did experienced substantial survival benefits. These results highlight the importance of routine cardiovascular surveillance in cancer patients and suggest that valvular interventions should not be withheld when clinically indicated.”

Autherith added that future work will explore how specific cancer treatments influence the development and progression of valvular disease, as well as outcomes following different interventions.

Notes to editor

Funding:

None
Disclosures: Doctor Autherith reports no disclosures related to this study.

References: 
1 ‘Valvular heart disease in cancer patients – prevalence, relevance, and therapeutic management –
preliminary results from the CESAR study’ presented during the Role of echocardiography on
cardio-oncology session on 11 December at 10:30 to 11:15 CET in Moderated ePoster 1.

2 Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC Guidelines on cardio-oncology developed
in collaboration with the European Hematology Association (EHA), the European Society for
Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J. 2022;43:4229–4361.

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EACVI 2025 (#EACVI2025) is a pioneering event that will bring together the fields of echocardiography, cardiovascular magnetic resonance (CMR), cardiac computed tomography (CT) and nuclear cardiology, providing healthcare professionals with a comprehensive and integrated perspective on the cutting-edge technology of cardiovascular imaging.

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SOURCE: European Society of Cardiology (ESC)