Current and emerging concepts of cardiotoxicity

Tsarouhas, Konstantinos; Kochiadakis, George E.; Docea, Anca Oana

doi:10.1016/b978-0-323-85215-9.00010-6

Cited by 1 publication

(1 citation statement)

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“…More specifically, the pathophysiological mechanism of AAS cardiotoxicity is justified since androgen receptors are located both in the endothelium of the vascular smooth muscles and in the myocardium. Although the mode of actions have not been entirely defined, anabolic steroid abuse has been causally linked to effects such as hypertension, myocardial ischemia, left ventricular hypertrophy, sudden cardiac death even in consumers younger than 30 years, heart attack or stroke [ 18 ].…”

Section: Roadmap For Identifying Regulatory Criteria On Cardiotoxicit...mentioning

confidence: 99%

Cardiotoxicity of Chemical Substances: An Emerging Hazard Class

Georgiadis

Tsarouhas

Dorne

et al. 2022

JCDD

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(1) Background: Human health risks and hazards from chemical substances are well regulated internationally. However, cardiotoxicity, is not defined as a stand-alone hazard and therefore there are no defined criteria for the classification of substances as cardiotoxic. Identifying and regulating substances that cause cardiovascular adverse effects would undoubtedly strengthen the national health systems. (2) Methods: To overcome the aforementioned gap, a roadmap is proposed for identifying regulatory criteria from animal studies and endorse legislation in order to classify substances as cardiotoxic. The roadmap consists of: (i) the identification of the appropriate animal species and strains; (ii) the identification of the lines of scientific evidence (e.g., histopathological, biochemical and echocardiographic indices etc.) from animal studies with relevance to humans; (iii) the statistical analysis and meta-analysis for each line of scientific evidence after exposure to well-established cardiotoxicants to humans (e.g., anthracyclines) in order to identify threshold values or range of normal and/ or altered values due to exposure; (iv) validation of the above described lines of evidence in animals exposed to other alleged cardiotoxic substances (e.g., anabolic androgen steroids (AAS) and pesticides); (v) establishment of mechanisms of action based on information of either known or alleged cardiotoxicants; and (vi) introduction of novel indices and in silico methods. (3) Results: Preliminary results in rats indicate a clear distinction from normal values to values measured in rats exposed to anthracyclines regarding left ventricle (LV) fractional shortening (FS) and LV ejection fraction (EF). A distinctive pattern is similarly observed for Creatine Kinase-Myocardial Band isoenzyme (CK-MB) and cardiac tissue glutathione (GSH). These findings are encouraging and indicate that there is room for targeted research to this end, and that these specific indices and biochemical markers should be further investigated in order to be developed to regulatory criteria. (4) Conclusions: Further research should be conducted by both the scientific and regulatory community that aims to clearly define the cardiotoxicity hazard caused by chemicals and develop a full set of scientific criteria.

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Section: Roadmap For Identifying Regulatory Criteria On Cardiotoxicit...mentioning

confidence: 99%