#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Cardiotoxicity – basic terms and mechanisms


Authors: R. Pudil
Authors‘ workplace: I. interní kardioangiologická klinika LF UK a FN Hradec Králové
Published in: Kardiol Rev Int Med 2017, 19(1): 7-10

Overview

Cardiotoxicity represents a very serious adverse effect of anti-tumour therapy. Cardiotoxicity includes a broad spectrum of symptoms: myocardial dysfunction and heart failure, coronary artery disease, valvular disease, arrhythmias (especially those induced by QT-prolonging drugs), arterial hypertension, thrombo­embolic disease, peripheral vascular disease and stroke, pulmonary hypertension and pericardial complications. The paper discusses the basic terms, mechanisms and diagnostic procedures for the detection of cardiotoxicity (ECG, echocardiography, CMR, biomarkers).

Keywords:
cardiotoxicity – heart failure – arrhythmias – electrocardiogram – echocardiography – cardiac markers


Sources

1. Zamorano JL, Lancel­lotti P, Rodriguez Muñoz D et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Com­mittee for Practice Guidelines. Eur Heart J 2016; 37(36): 2768– 2801.

2. Bloom MW, Hamo CE, Cardinale D et al. Cancer therapy-related cardiac dysfunction and heart failure: Part 1: definitions, pathophysiology, risk factors, and imaging. Circ Heart Fail 2016; 9(1): e002661. doi: 10.1161/ CIRCHEARTFAILURE.115.002661.

3. Tewey KM, Rowe TC, Yang L et al. Adriamycin-induced DNA damage mediated by mam­malian DNA topoisomerase II. Science 1984; 226(4673): 466– 468.

4. Vejpongsa P, Yeh ET. Topoisomerase 2beta: a promis­ing molecular target for primary prevention of anthracycline-induced cardiotoxicity. Clin Pharmacol Ther 2014; 95(1): 45– 52. doi: 10.1038/ clpt.2013.201.

5. Gershwin ME, Goetzl EJ, Steinberg AD. Cyclophosphamide: use in practice. Ann Intern Med 1974; 80(4): 531– 540.

6. Braverman AC, Antin JH, Plappert MT et al. Cyclophosphamide cardiotoxicity in bone mar­row transplantation: a prospective evaluation of new dos­ing regimens. J Clin Oncol 1991; 9(7): 1215– 1223.

7. Quezado ZM, Wilson WH, Cun­nion RE et al. High-dose ifosfamide is as­sociated with severe, reversible cardiac dysfunction. Ann Intern Med 1993; 118(1): 31– 36.

8. Field JJ, Kanakkanthara A, Mil­ler JH. Microtubule-target­ing agents are clinical­ly succes­sful due to both mitotic and interphase impairment of microtubule function. Bioorg Med Chemi 2014; 22(18): 5050– 5059. doi: 10.1016/ j.bmc.2014.02.035.

9. Giordano SH, Booser DJ, Mur­ray JL et al. A detailed evaluation of cardiac toxicity: a phase II study of doxorubicin and one- or three-hour-infusion paclitaxel in patients with metastatic breast cancer. Clin Cancer Res 2002; 8(11): 3360– 3368.

10. Pritchard KI, Shepherd LE, O'Mal­ley FP et al. HER2 and responsiveness of breast cancer to adjuvant chemotherapy. N Engl J Med 2006; 354(20): 2103– 2111.

11. Piccart-Gebhart MJ, Procter M, Leyland-Jones Bet al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Eng J Med 2005; 353(16): 1659– 1672.

12. Krop IE, Suter TM, Dang CT et al. Feasibility and cardiac safety of trastuzumab emtansine after anthracyclinebased chemotherapy as (neo)adjuvant therapy for human epidermal growth factor receptor 2positive early-stage breast cancer. J Clin Oncol 2015; 33(10): 1136– 1142. doi: 10.1200/ JCO.2014.58.7782.

13. Fer­rara N. Role of vascular endothelial growth factor in regulation of physiological angiogenesis. Am J Physiol Cell Physiol 2001; 280(6): 1358– 1366.

14. Pudil R, Horacek JM, Horackova J et al. Anthracycline therapy can induce very early increase in QT dispersion and QTc prolongation. Leuk Res 2008; 32(6): 998– 999.

15. Dorup I, Levitt G, Sul­livan I et al. Prospective longitudinal as­ses­sment of late anthracycline cardiotoxicity after childhood cancer: the role of diastolic function. Heart 2004; 90(10): 1214– 1216.

16. Pudil R, Horacek JM, Strasova A et al. Monitor­ing of the very early changes of left ventricular diastolic function with acute leucemia treated with anthracyclines. Exp Oncol 2008; 30(2): 160– 162.

17. Cardinale D, Sandri MT, Colombo A et al. Prog­nostic value of troponin I in cardiac risk stratification of cancer patients undergo­ing high-dose chemotherapy. Circulation 2004; 109(22): 2749– 2754.

18. Cardinale D, Sandri MT, Martinoni A et al. Left ventricular dysfunction predicted by early troponin I release after high-dose chemotherapy. J Am Coll Cardiol 2000; 36(2): 517– 522.

19. Horacek JM, Pudil R, Jebavy L et al. As­ses­sment of anthracycline induced cardiotoxicity with bio­chemical markers. Exp Oncol 2007; 29(4): 309– 313.

20. Kongbundansuk S, Hundley WG. Noninvasive imag­ing of cardiovascular injury related to the treatment of cancer. JACC Cardiovasc Imag­ing 2014; 7(8): 824– 838. doi: 10.1016/ j.jcmg.2014.06.007.

21. Yeh ET, Vejpongsa P. Subclinical cardiotoxicity as­sociated with cancer therapy: early detection and future directions. J Am Coll Cardiol 2015; 65(23): 2523– 2525. doi: 10.1016/ j.jacc.2015.04.012.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#