Cardiotoxicity in oncology and coronary microcirculation future challenges in theranostics nbsp

Abstract

The study of biomarkers and their related signalling pathways has allowed the development of new therapeutic strategies in a range of disorders. However, in hypertrophic cardiomyopathy (HCM), which is the most common hereditary cardiac disease, there are many potential biomarkers described, but their specificity and applicability for HCM remains an open field. The aim of the present review is to provide an overview of molecules that could give some insight into the pathophysiologic mechanisms underlying HCM, especially to those with "theranostic" - a combination of diagnostics and therapy - potential. The clinical and pre-clinical state of the art and theranostic perspectives of this topic will be part of the current discussion. The better understanding of this subject would provide an algorithm, to optimize the integration of diagnosis, prognostics and therapeutics findings in HCM, leading to a tailored approach for this pathology.

Complicaciones cardiovasculares agudas en una población peruana de pacientes oncológicos

“…Por el momento no existen escalas validadas para evaluar el riesgo cardiovascular en la población con cáncer 23 . Sin embargo, en este estudio, y de acuerdo con la escala de Hermann, muchos pacientes tenían un riesgo cardiovascular bajo (44,35%) o intermedio (33,3%), siendo el principal contribuyente al riesgo cardiovascular global, el riesgo individual de los pacientes y no el riesgo relacionado con la enfermedad o con el tratamiento.…”

“…Por estas razones, es necesario identificar los pacientes oncológicos en riesgo de toxicidad cardiovascular a través de una evaluación integral que identifique la disfunción cardíaca, el daño a los miocitos y su sobrecarga, así como la isquemia miocárdica 14 , 23 , 29 . Considerando algunas estrategias farmacológicas para los pacientes con un riesgo cardiovascular elevado, muchas de las recomendaciones incluyen el empleo de betabloqueadores y moduladores del sistema renina-angiotensina-aldosterona antes del empleo de los medicamentos oncológicos para evitar o reducir el riesgo de complicaciones cardiovasculares.…”

Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer

“…Blood flow was noninvasively measured as in most existing studies in cardio-oncology (1,39). While blood flow is directly related to vasodilation, it is not a measure of endothelial function.…”

“…Therefore, the combination of anthracyclines and CY represents an important strategy in the treatment of breast cancer. Unfortunately, these agents have been associated with increased risk of cardiovascular events, including endothelial dysfunction (11,16), increased circulating endothelial microparticles (EMPs) (40), acute coronary syndrome (21,39), myocarditis (1), supraventricular and ventricular arrhythmias (8,17), prolonged QT interval and systolic, and diastolic ventricular dysfunction (2,5,19), ultimately leading to heart failure (22).…”

Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women

“…However, there is increasing evidence supporting that the heart is actually a dose-limiting organ in RT [ 4 , 5 ]. The pathogenesis of radiation-induced coronary artery disease is complex and cardiac dysfunction and subsequent heart failure might be due to vascular toxicity and myocardial ischemia [ 6 ]. Radiation-induced heart disease includes a series of harmful effects on the heart, from subclinical histopathological findings to obvious clinical diseases.…”