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By Elvis Amao Internal Medicine , Cardiology and infectious diseases
George J Dugbartey, Luke J Peppone, Inge A M de Graaf
Cisplatin is currently one of the most widely-used chemotherapeutic agents against various malignancies. Its clinical application is limited, however, by inherent renal and cardiac toxicities and other side effects, of which the underlying mechanisms are only partly understood. Experimental studies show cisplatin generates reactive oxygen species, which impair the cell's antioxidant defense system, causing oxidative stress and potentiating injury, thereby culminating in kidney and heart failure. Understanding the molecular mechanisms of cisplatin-induced renal and cardiac toxicities may allow clinicians to prevent or treat this problem better and may also provide a model for investigating drug-induced organ toxicity in general...
October 4, 2016: Toxicology
Wei-Ting Chang, Jhih-Yuan Shih, Yin-Hsun Feng, Chun-Yen Chiang, Yu Hsuan Kuo, Wei-Yu Chen, Hong-Chang Wu, Juei-Tang Cheng, Jhi-Joung Wang, Zhih-Cherng Chen
BACKGROUND: As cancer therapies have improved, patient life spans have been extended but quality of life has been threatened by chemotherapy induced cardiotoxicity. Most cardiac complications remain unobserved until specific symptoms develop. Speckle-tracking echocardiography is a sensitive imaging modality in detecting early occult myocardial dysfunction. METHODS: A total number of 35 patients newly diagnosed with breast cancer and preparing for epirubicin therapy were prospectively recruited...
September 2016: Acta Cardiol Sin
Jean Domercant, Nichole Polin, Eiman Jahangir
BACKGROUND: Cardio-oncology is a collaborative approach between cardiologists and oncologists in the treatment of patients with cancer and heart disease. Radiation and chemotherapy have played a major role in the decreased cancer-related mortality achieved in the past 2 decades. However, anthracycline-, tyrosine kinase-, and radiation-based therapies are each associated with independent cardiovascular (CV) risks, and these risks are cumulative when these therapies are used in combination...
2016: Ochsner Journal
Edith Pituskin, Mark Haykowsky, Margaret McNeely, John Mackey, Neil Chua, Ian Paterson
BACKGROUND: Cancer is the leading cause of premature death in Canada. In the last decade, important gains in cancer survival have been achieved by advances in adjuvant treatment. However, many oncologic treatments also result in cardiovascular "toxicity". Furthermore, cardiac risk factors such as hypertension, dyslipidemia, and diabetes mellitus are known to contribute to the progression of cardiac damage and clinical cardiotoxicity. As such, for many survivors, the risk of death from cardiac disease exceeds that of recurrent cancer...
September 15, 2016: BMC Cancer
Tarek Magdy, Brian T Burmeister, Paul W Burridge
The cardiotoxicity of certain chemotherapeutic agents is now well-established, and has led to the development the field cardio-oncology, increased cardiac screening of cancer patients, and limitation of patients' maximum cumulative chemotherapeutic dose. The effect of chemotherapeutic regimes on the heart largely involves cardiomyocyte death, leading to cardiomyopathy and heart failure, or the induction of arrhythmias. Of these cardiotoxic drugs, those resulting in clinical cardiotoxicity can range from 8 to 26% for doxorubicin, 7-28% for trastuzumab, or 5-30% for paclitaxel...
September 5, 2016: Pharmacology & Therapeutics
Wendy J Bottinor, Christopher K Migliore, Carrie A Lenneman, Marcus F Stoddard
Patients with cancer can present with difficult management issues, as the medicine can sometimes cause sequelae destructive to healthy tissue. As this population lives longer, cardiotoxic effects are beginning to emerge, but the early recognition of this signal can prove difficult, with too late a recognition leading to lifelong cardiac impairment and dysfunction. Cardio-oncology can bridge this difficulty, and echocardiography and its newer imaging abilities are proving efficacious in this population. This article will address common sequelae of cardiotoxic treatment regimens and offer recommendations for echocardiographic surveillance...
October 2016: Current Cardiology Reports
Daniel K L Cheuk, Elske Sieswerda, Elvira C van Dalen, Aleida Postma, Leontien C M Kremer
BACKGROUND: Anthracyclines are frequently used chemotherapeutic agents for childhood cancer that can cause cardiotoxicity during and after treatment. Although several medical interventions in adults with symptomatic or asymptomatic cardiac dysfunction due to other causes are beneficial, it is not known if the same treatments are effective for childhood cancer patients and survivors with anthracycline-induced cardiotoxicity. This review is an update of a previously published Cochrane review...
2016: Cochrane Database of Systematic Reviews
Jing Zhang, Xiaohai Cui, Yan Yan, Min Li, Ya Yang, Jiansheng Wang, Jia Zhang
Anthracyclines, including doxorubicin, epirubicin, daunorubicin and aclarubicin, are widely used as chemotherapeutic agents in the treatment of hematologic and solid tumor, including acute leukemia, lymphoma, breast cancer, gastric cancer, soft tissue sarcomas and ovarian cancer. In the cancer treatment, anthracyclines also can be combined with other chemotherapies and molecular-targeted drugs. The combination of anthracyclines with other therapies is usually the first-line treatment. Anthracyclines are effective and potent agents with a broad antitumor spectrum, but may cause adverse reactions, including hair loss, myelotoxicity, as well as cardiotoxicity...
2016: American Journal of Translational Research
Manuela Fiuza, Leonor Ribeiro, Andreia Magalhães, Ana Rita Sousa, Miguel Nobre Menezes, Marília Jorge, Luís Costa, Fausto José Pinto
Considerable advances in cancer therapies in recent decades have reshaped the prognosis of cancer patients. There are now estimated to be over 20 million cancer survivors in the USA and Europe, numbers unimaginable a few years ago. However, this increase in survival, along with the aging of the patient population, has been accompanied by a rise in adverse cardiovascular effects, particularly when there is a previous history of heart disease. The incidence of cardiotoxicity continues to grow, which can compromise the effectiveness of cancer therapy...
September 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Robyn A Clark, Narelle M Berry, Munir H Chowdhury, Alexandra L McCarthy, Shahid Ullah, Vincent L Versace, John J Atherton, Bogda Koczwara, David Roder
BACKGROUND: Cardiotoxicity resulting in heart failure is a devastating complication of cancer therapy. A patient may survive cancer only to develop heart failure (HF) which has a higher mortality rate than some cancers. AIM: This project aimed to describe the characteristics and outcomes of HF in patients with blood or breast cancer after chemotherapy treatment. METHODS: Queensland Cancer Registry, Death Registry and Hospital Administration records were linked (1996-2009)...
August 9, 2016: Internal Medicine Journal
Valentina K Todorova, Issam Makhoul, Eric R Siegel, Jeanne Wei, Annjanette Stone, Weleetka Carter, Marjorie L Beggs, Aaron Owen, V Suzanne Klimberg
Cardiotoxicity of doxorubicin (DOX) remains an important health concern. DOX cardiotoxicity is cumulative-dose-dependent and begins with the first dose of chemotherapy. No biomarker for presymptomatic detection of DOX cardiotoxicity has been validated. Our hypothesis is that peripheral blood cells (PBC) gene expression induced by the early doses of DOX-based chemotherapy could identify potential biomarkers for presymptomatic cardiotoxicity in cancer patients. PBC gene expression of 33 breast cancer patients was conducted before and after the first cycle of DOX-based chemotherapy...
2016: PloS One
Yoshiko Saito, Ikuko Susukida, Yoshiro Uzuka, Hiroshi Kanai
Anthracyclines are among the most effective and widely used anticancer drugs; however, their use is limited by serious cardiotoxicity. Early detection is necessary to prevent the high mortality rate associated with heart failure (HF). We evaluated cardiac function in 142 patients using conventional echocardiography and the phased tracking method (PTM), which was measured using the minute vibration and the rapid motion components, neither of which is recognized in standard M-mode nor in tissue Doppler imaging...
September 2016: Cancer Medicine
L L M van Westerop, M Arts-de Jong, N Hoogerbrugge, J A de Hullu, A H E M Maas
BRCA1/2 mutation carriers are at high risk of breast and ovarian cancer. The number of studies on non-cancer endpoints in BRCA1/2 mutation carriers is still limited. BRCA1/2 mutation carriers may be at higher cardiovascular risk due to early menopause after risk-reducing salpingo-oophorectomy and/or due to the potential cardiotoxic effects of breast cancer treatment (radiotherapy and chemotherapy). Moreover, BRCA genes have a role as a gatekeeper in cardiac function and structure, which may affect susceptibility to cardiac damage...
September 2016: Maturitas
Agathe Potier, Stéphane Ederhy, Yann Ancedy, Arnaud Etienney, Laurie Soulat-Dufour, Marion Chauvet, Antoine Hollebecque, Saroumadi Adavane-Scheuble, Franck Boccara, Jean-Charles Soria, Ariel Cohen
Anthracyclines and molecular targeted agents have improved prognosis of patients undergoing chemotherapeutics for malignancy. However, the use of these therapies is limited because of risk of cardiac toxicity. The severity of the cardiomyopathy can range from an asymptomatic left ventricular (LV) dysfunction to a severe congestive heart failure. Cardiomyopathy can be reversible or irreversible according to the type of chemotherapy, modality of administration and patient's characteristics. Several studies aimed to early detection and the evaluation of tools to characterize patients at risk to develop cardiac side effects in order to prevent severe LV dysfunction...
July 2016: Bulletin du Cancer
Nandini Nair, Enrique Gongora
Medical therapies in oncology have resulted in better survival resulting in a large population who are at risk of early and late cardiac complications of chemotherapy. Cardiotoxicity related to chemotherapy can manifest decades after treatment with a threefold higher mortality rate as compared to idiopathic dilated cardiomyopathy. The leading cause of death in cancer survivors seems to be cardiac. Early detection and intervention could prevent progression of heart failure to end stage disease requiring advanced therapies such as implantation of ventricular assist devices or cardiac transplantation...
December 2016: BBA Clinical
Andrea Denegri, Tiziano Moccetti, Marco Moccetti, Paolo Spallarossa, Claudio Brunelli, Pietro Ameri
Breast cancer (BC) is diagnosed in ≥ 65 year old women in about half of cases. Experts currently recommend that systemic therapy is offered to elderly patients with BC, if, based on their overall conditions and life expectancy, it can be reasonably anticipated that the benefits will outweigh the risks of treatment. Like for young subjects, the monoclonal antibody against human epidermal growth factor receptor-2 (HER-2), trastuzumab, represents a valid therapeutic option when BC over-expresses this receptor...
May 2016: Journal of Geriatric Cardiology: JGC
Annelies H Boekhout, Jourik A Gietema, Bojana Milojkovic Kerklaan, Erik D van Werkhoven, Renske Altena, Aafke Honkoop, Maartje Los, Willem M Smit, Peter Nieboer, Carolien H Smorenburg, Caroline M P W Mandigers, Agnes J van der Wouw, Lonneke Kessels, Annette W G van der Velden, Petronella B Ottevanger, Tineke Smilde, Jaap de Boer, Dirk J van Veldhuisen, Ido P Kema, Elisabeth G E de Vries, Jan H M Schellens
IMPORTANCE: This is the first randomized placebo-controlled evaluation of a medical intervention for the prevention of trastuzumab-related cardiotoxic effects. OBJECTIVE: To determine as the primary end point whether angiotensin II antagonist treatment with candesartan can prevent or ameliorate trastuzumab-related cardiotoxic effects, defined as a decline in left ventricular ejection fraction (LVEF) of more than 15% or a decrease below the absolute value 45%. DESIGN: This randomized, placebo-controlled clinical study was conducted between October 2007 and October 2011 in 19 hospitals in the Netherlands, enrolling 210 women with early breast cancer testing positive for human epidermal growth factor receptor 2 (HER2) who were being considered for adjuvant systemic treatment with anthracycline-containing chemotherapy followed by trastuzumab...
August 1, 2016: JAMA Oncology
Ibrahim Fanous, Patrick Dillon
Cancer therapies, especially anthracyclines and monoclonal antibodies, have been linked with increased rates of cardiotoxicity. The development of some cardiac side effects happens over several months, and changes in ejection fraction can be detected long before permanent damage or disability occurs. Advanced heart failure could be averted with better and earlier detection. Methodologies for early detection of cardiac changes include stress echocardiograms, cardiac velocity measurements, radionuclide imaging, cardiac MRI and several potential biomarkers...
August 2016: Medical Oncology
Husam Abdel-Qadir, Mark T Nolan, Paaladinesh Thavendiranathan
The inevitability of cardiac injury in many patients treated for cancer mandates strategies to mitigate the effect of cancer treatment on the heart. In this article we argue that the best approach to prevent cardiotoxicity is universal primary prevention for everyone at risk for irreversible myocardial injury. Our viewpoint is on the basis of 5 major arguments that we discuss in detail in this article. We outline the shortcomings of alternate strategies for prevention and highlight that the strongest existing evidence today supports our viewpoint...
July 2016: Canadian Journal of Cardiology
Christine C Davis, Amelia Zelnak, J William Eley, Daniel A Goldstein, Jeffrey M Switchenko, Trevor McKibbin
BACKGROUND: Trastuzumab targets the human epidermal growth factor receptor-2 (HER2). Cardiotoxicity is a potential adverse effect, manifesting as either an asymptomatic decline in left-ventricular ejection fraction or infrequently as largely reversible symptomatic heart failure (HF). Monitoring recommendations differ between product labeling and 2012 guidelines, and the clinical utility of serial cardiac monitoring in patients with metastatic breast cancer remains controversial. OBJECTIVE: The objectives of this study were to describe the frequency of monitoring, incidence of symptomatic or asymptomatic HF, overall effect on treatment, and cost of monitoring for cardiotoxicity...
September 2016: Annals of Pharmacotherapy
2016-06-28 21:23:04
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