A systematic review of the pathophysiology of 5-fluorouracil-induced cardiotoxicity

Polk, Anne; Vistisen, Kirsten; Vaage-Nilsen, Merete; Nielsen, Dorte

doi:10.1186/2050-6511-15-47

Cited by 215 publications

(175 citation statements)

References 79 publications

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“…The pathophysiology of 5-FU-induced cardiotoxicity is controversial, and conclusions are based on clinical studies and case reports to a greater extent than on experimental evidence (48). Furthermore, 5-FU cardiotoxicity is suspected to be mediated by coronary vasospasm and free radical damage to the myocardium (13,49).…”

Section: Discussionmentioning

confidence: 99%

Attenuation effect of Abnormal Savda Munziq on liver and heart toxicity caused by chemotherapy in mice

Aikemu

Amat

Yusup

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Abnormal Savda Munziq (ASMq), an Uighur medicine formula commonly used in the treatment of cancer, has been speculated to possess antioxidative and antiproliferative effects, and to regulate immune activity. The present study was designed to systematically elucidate the toxicity-reducing activity of ASMq in mice undergoing combination chemotherapy with doxorubicin and 5-fluorouracil (5-FU). The mice were divided into normal (saline, 10 ml/kg) and doxorubicin + 5-FU groups (doxorubicin, 2.5 mg/kg; 5-FU, 10 mg/kg on alternate days). In addition, three groups received different doses of ASMq (2, 4 and 8 g/kg), in addition to doxorubicin (2.5 mg/kg) and 5-FU (10 mg/kg) treatment on alternate days. The histology of the heart and liver, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, malondialdehyde (MDA) concentrations in heart homogenate, and various biochemical parameters of the liver were evaluated. Compared with the normal control group, ASMq dose-dependently improved a number of variables, including body weight, liver index, transaminase and total protein, and partially normalized liver and cardiac pathology. ASMq restored activities of defense antioxidant enzymes SOD and GSH-Px towards normal levels, and decreased MDA concentration in dose-dependent manner. These results demonstrated that ASMq provides significant protection against doxorubicin + 5-FU combination induced hepatotoxicity and cardiotoxicity. Further studies are required to determine the effects of ASMq against doxorubicin + 5-FU-induced toxicity during chemotherapy in vivo.

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Section: Discussionmentioning

confidence: 99%

Attenuation effect of Abnormal Savda Munziq on liver and heart toxicity caused by chemotherapy in mice

Aikemu

Amat

Yusup

et al. 2016

Experimental and Therapeutic Medicine

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“…Moment wykrywania kardiotoksyczności za pomocą echokardiografii i oznaczeń biomarkerów musi być zindywidualizowany i uwzględniać u pacjentów początkowe ryzyko CV oraz zastosowany protokół leczenia onkologicznego. Najważniejszym elementem jest stratyfikacja ryzyka w celu ustalenia częstości tej oceny i zapewniania, że u osób z grupy większego ryzyka będzie ona dokonywana wcześniej, aby nie przeoczyć wczesnej toksyczności [115]. Jest to oparte na opinii ekspertów, ponieważ nie ma dowodów dotyczących optymalnej strategii nadzoru, która korzystnie wpływałaby na kliniczne wyniki terapii.…”

Section: Narzędzia Diagnostyczne Wykorzystywane Do Wykrywania Toksyczunclassified

“…Częstość występowania niedokrwienia mięśnia sercowego wykazuje znaczną zmienność, ale może wynosić nawet 10% w zależności od dawki, schematu podawania leku oraz drogi jego podawania [117]. Mechanizmy niedokrwienia mięśnia sercowego wywoływanego przez 5-FU są wieloczynnikowe i obejmują skurcz naczyń wieńcowych i uszkodzenie śródbłonka [115]. Ból w klatce piersiowej i zmiany niedokrwienne w EKG występują typowo w spoczynku, natomiast rzadziej podczas wysiłku, w ciągu dni od podania leku i czasami utrzymują się nawet po przerwaniu terapii.…”

Section: Fluoropirimidynyunclassified

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

Zamorano¹,

Lancellotti²,

Muñoz³

et al. 2016

Kardiol Pol

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“…The cardiotoxic effects of these drugs seem to be multifactorial [16]. The suggested phenomenon of vasospasm induced by 5-FU or capecitabine cannot explain the possibility of cardiomyopathy, sinoatrial and atrioventricular node dysfunction, takotsubo cardiomyopathy, and QT prolongation with torsade de pointes ventricular tachycardia [17].…”

Section: Discussionmentioning

confidence: 99%

Tissue Doppler echocardiography detects subclinical left ventricular dysfunction in patients undergoing chemotherapy for colon cancer: insights from ONCOECHO multicentre study

et al. 2017

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A b s t r a c tBackground: Colorectal cancer (CRC) is the second most common cancer in women and the third in men in Poland. The role of chemotherapy (CTX) depends on the stage of CRC: adjuvant CTX is a standard treatment in stage III and should also be considered in stage II with risk factors. Aim:The aim of the paper was to assess the cardiovascular consequences of CTX in CRC enrolled to the ONCOECHO multicentre study (2012)(2013)(2014). To identify potential cardiotoxicity, we focused on myocardial function, heart rhythm and conduction disorders, and adverse cardiovascular events.Methods: Twenty-five CRC patients (12 women, mean age 61.3 years), all receiving six-month adjuvant CTX were included. Thirteen patients received 5-fluorouracil (5FU)-based CTX, and 12 patients received a capecitabine-based scheme. Subjects were assessed at baseline and followed-up three, six, and 12 months after the onset of treatment. In this analysis we focused on conduction abnormalities, systolic and diastolic function of the left ventricle (LV), and cardiovascular events. Results:In 12-month follow-up a decrease of selected tissue Doppler parameters (e.g. S'IVS, S'lat, and E'sept) was observed, and it was significant. LV structural parameters and ejection fraction (EF) remained unaffected. Changes in myocardial performance were not influenced by CTX regimen or treatment with beta-blockers or angiotensin-converting enzyme inhibitors. CTX did not affect LV structural parameters, EF, or conduction system, nor was it associated with cardiovascular events during the 12-month follow-up.Conclusions: CTX in CRC patients does not affect LV structural parameters and EF. It may, however, trigger subtle changes in myocardial performance detectable by tissue Doppler echocardiography after 12 months. Moreover, it causes a transient increase of QT, which resolves after CTX cessation.

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A systematic review of the pathophysiology of 5-fluorouracil-induced cardiotoxicity

Cited by 215 publications

References 79 publications

Attenuation effect of Abnormal Savda Munziq on liver and heart toxicity caused by chemotherapy in mice

Attenuation effect of Abnormal Savda Munziq on liver and heart toxicity caused by chemotherapy in mice

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

Tissue Doppler echocardiography detects subclinical left ventricular dysfunction in patients undergoing chemotherapy for colon cancer: insights from ONCOECHO multicentre study

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