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cardio-oncology: The Need of the Hour Subspeciality

World Journal of cardiovascular Diseases 2024年第4期14卷 187-194页

作者： Agyanta Dhal SCB Medical College and Hospital Cuttack India

There have been considerable advancements in cancer therapy in recent years. However, adverse effects often defeat the benefits, especially on the cardiovascular system. The effects of chemotherapeutic agents on the cardiovascular system can be directly on the heart by altering the coagulability state or by altering the hemodynamic system. Some drugs like Sunitinib and Bevacizumab show Heart Failure which is chemotherapy-induced. Other agents are notorious for showing QT prolongation like Vandetanib. Similarly, other agents with demonstrated cardiotoxicity would be molecular-targeted drugs (Trastuzumab and Pertuzumab) and cytostatic agents (Anthracycline antibiotics, Cyclophosphamide and 5-FU). These effects may present early or late, during or after the treatment. Most of the research has focused on the management and monitoring of patients for cancer who are under treatment, for example new biomarkers in the field of proteomics have been discovered for the diagnosis, treatment, and monitoring of patients. While the upgrades have been successful in reducing mortalities, with the advent of better treatment outcomes, the several adverse effects on the cardiac system cannot be dismissed. For instance, damage to the cardiomyocytes is most frequently associated with the treatment. The damage can further expedite LV failure, valvular dysfunction, conduction abnormalities, etc. Hence, a better management plan for patients with cancer would be one that not only caters to primary cancer treatment but also incorporates ventricular systolic function evaluation using echocardiography, electrocardiography, and cardiac biomarkers for the well-being of patients. Our article focuses on introducing an ideal cardio-oncology team along with the components required for setting up the team. This needs a multidisciplinary approach to reduce patients’ cardiovascular morbidity, during and after the interventions. With the growing population of patients undergoing cancer therapy, the risk

关键词： Cancer cardio-oncology Services Multidisciplinary Team cardiovascular Disease

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Evolving field of cardio-oncology

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Cancer Pathogenesis and Therapy 2023年第2期1卷 141-145页

作者： Guo Li Lijun Zhang Meiyan Liu Department of Psycho-cardiology Beijing Anzhen HospitalBeijing 100029China

Therapy development for cancer and cardiovascular disease(CVD)to prolong lifespan makes the relationship between these two conditions more *** interactions in cardiology and oncology are associated with metabolism and drug *** in biomarkers and imaging provide novel methods for detecting cardiotoxicity,including cardiac injury and *** new concept of CVD-related cancer risk is leading to a new direction of progression termed“reverse cardio-oncology.”

关键词： cardio-oncology cardiotoxicity Reverse cardio-oncology

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Emergence, development, and future of cardio-oncology in China: cardiohypersensitivity, cardiotoxicity and the Kounis syndrome

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Chinese Medical Journal 2019年第6期132卷 753-754页

作者： Nicholas G. Kounis Ioanna Koniari Panagiotis Plotas George D. Soufras Grigorios Tsigkas Periklis Davlouros George Hahalis Department of cardiology University of Patras Medical School Rion Patras Achaia Greece Department of Electrophysiology Queen Elizabeth Hospital Birmingham England United Kingdom Department of Public Health School of Medicine University of Patras Greece Department of cardiology "Saint Andrews" State General Hospital Patras Achaia Greece

To the Editor:Cancer and cardiovascular disease constitute the two major causes of death worldwide. Whereas the incidence of cancer increases among adults up to 74 years of age, above this age the cardiovascular disease surpasses cancer as the primary cause of mortality.[1] Currently, chemotherapy, radiation therapy, and surgery are the main modalities for the treatment of cancer. However, chemotherapy can induce cardiovascular worsening, manifesting as acute and chronic symptomatology. Therefore, the verv interesting report published in Chinese Medical Journal[2] concerning a 60-year-old male patient suffering from coronary artery disease and squamous cell carcinoma of the left lung who developed an ST segment elevation myocardial infarction following treatment with afatinib (tyrosine kinase inhibitor) and gemcitabine (antimetabolite pyrimidine antagonist) and cisplatin (platinum based DNA replication inhibitor) and the subsequent discussion raise several important considerations on cardiac toxicity, cardiac hypersensitivity and the Kounis-hypersensitivity acute coronary syndrome.

关键词： To the Editor Emergence development cardio-oncology

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Insights into cardio-oncology:Polypharmacology of quinazoline-based α1-adrenoceptor antagonists

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World Journal of cardiology 2015年第5期7卷 238-242页

作者： Salvatore Patanè cardiologia Ospedale San Vincenzo Taormina(Me) Azienda Sanitaria Provinciale di Messina98039 TaorminaMessinaItaly

New uses of cardiovascular drugs with proven experience are emerging,including for treating *** is a compound made up of two fused six member simple aromatic rings,benzene and pyrimidine rings,with several biological *** first used quinazoline-based α1-adrenoceptor antagonists prazosin,doxazosin,and terazosin; currently available data support their use as safe,well tolerated,and effective add-on therapy in uncontrolled hypertension with additional favourable metabolic *** findings highlight the anticancer effects of quinazoline-based α1-adrenoceptor antagonists,indicating that they may have a significant role in uncontrolled hypertensive cancer patients without signs of ischemia.

关键词： cardio-oncology Multidrug resistance Prazosin Terazosin Doxazosin

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Approach to cardiac masses: Thinking inside and outside the box

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World Journal of Clinical Cases 2024年第28期12卷 6132-6136页

作者： Elia De Maria Chief of Arrhythmology Lab Cardiology UnitRamazzini HospitalCarpi 41012ModenaItaly

In this editorial we comment on the article by Huffaker et al,published in the current issue of the World Journal of Clinical *** masses encompass a broad range of lesions,potentially involving any cardiac structure,and they can be either neoplastic or *** cardiac tumors are rare,while metastases and pseudotumors are relatively *** masses frequently pose significant diagnostic and therapeutic *** imaging is fundamental for differential diagnosis,treatment,and surgical *** particular cardiac magnetic resonance(CMR)is currently the gold standard for noninvasive tissue *** allows evaluation of the relationship between the tumor and adjacent structures,detection of the degree of infiltration or expansion of the mass,and prediction of the possible malignancy of a mass with a high *** flow charts of diagnostic work-up have been proposed,based on clinical,laboratory and imaging findings,with the aim of helping physicians approach the problem in a pragmatic way(“thinking inside the box”).However,the clinical complexity of cancer patients,in particular those with rare syndromes,requires a multidisciplinary approach and an open mind to go beyond flow charts and diagnostic algorithms,in other words the ability to“think outside the box”.

关键词： Cardiac masses Cardiac tumors cardio-oncology Cardiac magnetic resonance Primitive cardiac tumors

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Resveratrol activation of SIRT1/MFN2 can improve mitochondria function,alleviating doxorubicin-induced myocardial injury

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Cancer Innovation 2023年第4期2卷 253-264页

作者： Qingling Zhang Yunpeng Zhang Bingxin Xie Daiqi Liu Yueying Wang Zandong Zhou Yue Zhang Emma King Gary Tse Tong Liu Department of cardiology Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular DiseaseTianjin Institute of CardiologyThe Second Hospital of Tianjin Medical UniversityTianjinChina Epidemiology Research Unit Cardiovascular Analytics GroupChina-UK CollaborationHong KongChina Kent and Medway Medical School CanterburyKentUK

Background Doxorubicin is a widely used cytotoxic chemotherapy agent for treating different ***,its use is associated with dose-dependent cardiotoxicity,causing irreversible myocardial damage and significantly reducing the patient's quality of life and *** this study,an animal model of doxorubicin-induced cardiomyopathy was used to investigate the pathogenesis of doxorubicin-induced myocardial *** study also investigated a possible treatment strategy for alleviating myocardial injury through resveratrol therapy in *** Adult male C57BL/6J mice were randomly divided into a control group and a doxorubicin *** weight,echocardiography,surface electrocardiogram,and myocardial histomorphology were *** mechanisms of doxorubicin cardiotoxicity in H9c2 cell lines were explored by comparing three groups(phosphate-buffered saline,doxorubicin,and doxorubicin with resveratrol).Results Compared to the control group,the doxorubicin group showed a lower body weight and higher systolic arterial pressure,associated with reduced left ventricular ejection fraction and left ventricular fractional shortening,prolonged PR interval,and QT *** abnormalities were associated with vacuolation and increased disorder in the mitochondria of cardiomyocytes,increased protein expression levels of α-smooth muscle actin and caspase 3,and reduced protein expression levels of Mitofusin2(MFN2)and Sirtuin1(SIRT1).Compared to the doxorubicin group,doxorubicin+resveratrol treatment reduced caspase 3 and manganese superoxide dismutase,and increased MFN2 and SIRT1 expression *** Doxorubicin toxicity leads to abnormal mitochondrial morphology and dysfunction in cardiomyocytes and induces apoptosis by interfering with mitochondrial *** ameliorates doxorubicin-induced cardiotoxicity by activating SIRT1/MFN2 to improve mitochondria function.

关键词： cardio-oncology doxorubicin-induced cardiomyopathy mitochondriafunction resveratrol SIRT1 agonists

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Analysis of Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor-Induced Left Ventricular Dysfunction

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Journal of Biophysical Chemistry 2023年第2期14卷 67-78页

作者： Yasuhisa Hashino Kengo Umehara Shinya Takada Kuninori Iwayama Koichi Ohtaki Hideki Sato Faculty of Pharmaceutical Sciences Hokkaido University of Science Sapporo Japan Department of Pharmacy National Hospital Organization Hokkaido Cancer Center Sapporo Japan

Vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitor (VEGFR-TKI), an oral molecular targeted drug, reportedly causes serious adverse cardiovascular events such as hypertension and left ventricular failure. The association between VEGFR-TKI-induced hypertension and heart failure with preserved left ventricular ejection fraction (LVEF) (HFpEF) has been previously studied. Therefore, we investigated the relationship between hypertension onset and associated cardiac diastolic dysfunction due to VEGFR-TKI use. Patients who used VEGFR-TKIs (target drugs: sunitinib, axitinib, sorafenib, pazopanib, and cabozantinib) at the Department of Urology, Hokkaido Cancer Center were recruited between May 2009 and October 2021 and were divided into two groups based on whether their blood pressure was elevated during VEGFR-TKI use. The markers of left ventricular diastolic function (E/A, Dct (ms), mean E/e, septal e') and left ventricular systolic function (LVEF, LVDd, and LVDs) were evaluated. LVEF and mean E/e in the elevated blood pressure group (n = 41) showed significant changes before and after treatment. LVEF values (contractile function markers) in the TKI-HT (+) group significantly decreased from 70.7% ± 6.8% before treatment to 68.3% ± 7.8% after treatment (p = 0.03). Conversely, no significant difference was observed for any ventricular systolic function marker in the TKI-HT (−) group. E/e (diastolic function marker) in the TKI-HT (+) group significantly decreased from 11.9% ± 3.6% before treatment to 10.3% ± 3.0% after treatment (p = 0.02). However, no change was observed in any ventricular diastolic function marker in the TKI-HT (−) group. The results of this study suggest that cardiac function may be affected in patients using VEGFR-TKI. Furthermore, appropriate antihypertensive treatment and early monitoring with regular echocardiography, even in asymptomatic patients, may help prevent VEGFR-TKI-induced deterioration of systolic and diastolic func

关键词： VEGFR-TKI Left Ventricular Dysfunction cardio-oncology HFrEF HFpEF CTRCD

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Secondary lymphoma develops in the setting of heart failure when treating breast cancer: A case report

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World Journal of Clinical Cases 2019年第12期7卷 1492-1498页

作者： Sen Han Tao An Wei-Ping Liu Yu-Qin Song Jun Zhu Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education) Department of Lymphoma Peking University Cancer Hospital and Institute Beijing 100142 China Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Science and Peking Union Medical College Heart Failure Center Beijing 100142 China

BACKGROUND cardiovascular side effects occur frequently during anti-cancer treatment, and there is a growing concern that they may lead to premature morbidity and death. CASE SUMMARY A 32-year-old woman was diagnosed with breast cancer. After comprehensive treatment with neoadjuvant chemotherapy, surgery, postoperative adjuvant chemotherapy, postoperative adjuvant radiotherapy, and endocrine therapy, her breast cancer was cured. However, heart failure associated with anti-cancer treatment presented, most probably related to chemotherapy containing anthracycline. After active treatment, her cardiac function returned to normal. Unfortunately, follow-up visits revealed a second primary malignancy, lymphoma. After multiple courses of chemotherapy combined with targeted therapy, her lymphoma acquired complete remission and no cardiotoxicity was observed again. Heart failure related to breast treatment may be reversible. CONCLUSION Using alternatives to anthracycline in patients with lymphoma who are at risk of cardiac failure may preserve cardiac function.

关键词： Breast cancer Chemotherapy Cardiac toxicity Heart failure Anthracycline cardio-oncology Case report

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Optimal management of coronary artery disease in cancer patients

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Chronic Diseases and Translational Medicine 2019年第4期5卷 221-233页

作者： Xue-Jie Han Jian-Qiang Li Zulfiia Khannanova Yue Li Department of cardiology The First Affiliated Hospital of Harbin Medical UniversityHarbin Medical UniversityHarbinHeilongjiang 150001China Bashkir State Medical University UfaRepublic BashkortostanRussia

Owing to early diagnosis and rapid development of treatments for cancers,the five-year survival rate of all cancer types has markedly improved *** time,however,there has been an increase in the number of cancer patients who develop coronary artery disease(CAD)due to different ***,many risk factors are shared between cancer and ***,inflammation and oxidative stress are common underlying pathogeneses in both ***,cancer therapy can result in endothelial injury,coronary artery spasm,and coagulation,thereby increasing the risk of *** more cancer patients are being diagnosed with CAD,specialized cardiac care should be established to minimize the cardiovascular mortality of cancer survivors.

关键词： Cancer Coronary artery disease cardio-oncology

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cardiovascular risk management in cancer survivors:Are we doing it right?

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World Journal of Clinical oncology 2021年第3期12卷 144-149页

作者： Turab Mohammed Tarang Parekh Aakash Desai Department of Medicine University of ConnecticutFarmingtonCT 06030United States Department of Health Administration and Policy George Mason UniversityFairfaxVA 22030United States Department of Hematology and oncology Mayo ClinicRochesterMN 55902United States

Although under-recognized,cancer survivors continue to be at an increased risk of death from cardiovascular complications post-remission or *** increased burden of cardiovascular disease results from the interplay of various *** cardiovascular risk assessment and timely intervention through a multi-disciplinary approach in these patients plays a pivotal role in the prevention of cardiovascular morbidity and *** discuss the shortcomings of using current risk prediction scores in cancer survivors and provide some insights into cardiovascular risk management relevant for primary care physicians,oncologists,and cardiologists alike.

关键词： Cancer survivors cardio-oncology Atherosclerotic cardiovascular disease risk estimator cardiovascular disease risk Childhood cancer survivor study Cancer policy

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