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Subclinical cardiac damage in cancer patients before chemotherapy

Cancer and cardiovascular diseases, including heart failure (HF), are the main causes of death in Western countries. Several anticancer drugs and radiotherapy have adverse effects on the cardiovascular system, promoting left ventricular dysfunction and ultimately HF. Nonetheless, the relationship be...

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Autores principales: Fabiani, Iacopo, Panichella, Giorgia, Aimo, Alberto, Grigoratos, Chrysanthos, Vergaro, Giuseppe, Pugliese, Nicola Riccardo, Taddei, Stefano, Cardinale, Daniela Maria, Passino, Claudio, Emdin, Michele, Giannoni, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197815/
https://www.ncbi.nlm.nih.gov/pubmed/34318387
http://dx.doi.org/10.1007/s10741-021-10151-4
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author Fabiani, Iacopo
Panichella, Giorgia
Aimo, Alberto
Grigoratos, Chrysanthos
Vergaro, Giuseppe
Pugliese, Nicola Riccardo
Taddei, Stefano
Cardinale, Daniela Maria
Passino, Claudio
Emdin, Michele
Giannoni, Alberto
author_facet Fabiani, Iacopo
Panichella, Giorgia
Aimo, Alberto
Grigoratos, Chrysanthos
Vergaro, Giuseppe
Pugliese, Nicola Riccardo
Taddei, Stefano
Cardinale, Daniela Maria
Passino, Claudio
Emdin, Michele
Giannoni, Alberto
author_sort Fabiani, Iacopo
collection PubMed
description Cancer and cardiovascular diseases, including heart failure (HF), are the main causes of death in Western countries. Several anticancer drugs and radiotherapy have adverse effects on the cardiovascular system, promoting left ventricular dysfunction and ultimately HF. Nonetheless, the relationship between cancer and HF is likely not unidirectional. Indeed, cancer and HF share common risk factors, and both have a bidirectional relationship with systemic inflammation, metabolic disturbances, and neurohormonal and immune activation. Few studies have assessed the impact of untreated cancer on the heart. The presence of an active cancer has been associated with elevated cardiac biomarkers, an initial impairment of left ventricular structure and function, autonomic dysfunction, and reduced exercise tolerance. In turn, these conditions might increase the risk of cardiac damage from chemotherapy and radiotherapy. HF drugs such as beta-blockers or inhibitors of the renin–angiotensin–aldosterone system might exert a protective effect on the heart even before the start of cancer therapies. In this review, we recapitulate the evidence of cardiac involvement in cancer patients naïve from chemotherapy and radiotherapy and no history of cardiac disease. We also focus on the perspectives for an early diagnosis and treatment to prevent the progression to cardiac dysfunction and clinical HF, and the potential benefits of cardioactive drugs on cancer progression.
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spelling pubmed-91978152022-06-16 Subclinical cardiac damage in cancer patients before chemotherapy Fabiani, Iacopo Panichella, Giorgia Aimo, Alberto Grigoratos, Chrysanthos Vergaro, Giuseppe Pugliese, Nicola Riccardo Taddei, Stefano Cardinale, Daniela Maria Passino, Claudio Emdin, Michele Giannoni, Alberto Heart Fail Rev Article Cancer and cardiovascular diseases, including heart failure (HF), are the main causes of death in Western countries. Several anticancer drugs and radiotherapy have adverse effects on the cardiovascular system, promoting left ventricular dysfunction and ultimately HF. Nonetheless, the relationship between cancer and HF is likely not unidirectional. Indeed, cancer and HF share common risk factors, and both have a bidirectional relationship with systemic inflammation, metabolic disturbances, and neurohormonal and immune activation. Few studies have assessed the impact of untreated cancer on the heart. The presence of an active cancer has been associated with elevated cardiac biomarkers, an initial impairment of left ventricular structure and function, autonomic dysfunction, and reduced exercise tolerance. In turn, these conditions might increase the risk of cardiac damage from chemotherapy and radiotherapy. HF drugs such as beta-blockers or inhibitors of the renin–angiotensin–aldosterone system might exert a protective effect on the heart even before the start of cancer therapies. In this review, we recapitulate the evidence of cardiac involvement in cancer patients naïve from chemotherapy and radiotherapy and no history of cardiac disease. We also focus on the perspectives for an early diagnosis and treatment to prevent the progression to cardiac dysfunction and clinical HF, and the potential benefits of cardioactive drugs on cancer progression. Springer US 2021-07-27 2022 /pmc/articles/PMC9197815/ /pubmed/34318387 http://dx.doi.org/10.1007/s10741-021-10151-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Fabiani, Iacopo
Panichella, Giorgia
Aimo, Alberto
Grigoratos, Chrysanthos
Vergaro, Giuseppe
Pugliese, Nicola Riccardo
Taddei, Stefano
Cardinale, Daniela Maria
Passino, Claudio
Emdin, Michele
Giannoni, Alberto
Subclinical cardiac damage in cancer patients before chemotherapy
title Subclinical cardiac damage in cancer patients before chemotherapy
title_full Subclinical cardiac damage in cancer patients before chemotherapy
title_fullStr Subclinical cardiac damage in cancer patients before chemotherapy
title_full_unstemmed Subclinical cardiac damage in cancer patients before chemotherapy
title_short Subclinical cardiac damage in cancer patients before chemotherapy
title_sort subclinical cardiac damage in cancer patients before chemotherapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197815/
https://www.ncbi.nlm.nih.gov/pubmed/34318387
http://dx.doi.org/10.1007/s10741-021-10151-4
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