Development of Cancer in Patients With Heart Failure: How Systemic Inflammation Can Lay the Groundwork

Abstract

In the last decade, cardiologists and oncologists have provided clinical and experimental evidence that cancer, and not only chemotherapeutic agents, can cause detrimental effects on heart structure and function, a consequence that has serious clinical implications for patient management. In parallel, the intriguing idea that heart failure (HF) may be an oncogenic condition has also received growing attention. A number of epidemiological and clinical studies have reported that patients with HF have a higher risk of developing cancer. Chronic low-grade systemic inflammation has been proposed as a major pathophysiological process linking the failing heart to the multi-step process of carcinogenesis. According to this view, pro-inflammatory mediators secreted by the damaged heart generate a favorable milieu that promotes tumor development and accelerates malignant transformation. HF-associated inflammation synergizes with tumor-associated inflammation, so that over time it is no longer possible to distinguish the effects of one or the other. Experimental studies have just begun to search for the molecular effectors of this process, with the ultimate goal that of identifying mechanisms suitable for anti-cancer target therapy to reduce the risk of incident cancer in patients already affected by HF. In this review we critically discuss strengths and limitations of clinical and experimental studies that support a causal relationship between HF and cancer, and focus on HF-associated inflammation, cardiokines and their endocrine functions linking one and the other disease.

Mechanism of Baoyuan Decoction in the Treatment of Chronic Heart Failure Based on Network Pharmacology

“…The activated NF-κβ and STAT3 pathways promote the proliferation of CSCs. TNF-α, IL-6 and TGF-β induce tumor cell migration and activation of cancer cells [32] , suggesting an interaction between heart failure and cancer.…”

Associação entre Insuficiência Cardíaca Crônica e Risco de Câncer: Uma Revisão de Literatura / Association Between Chronic Heart Failure and Cancer Risk: A Literature Review

“…Além disso, uma outra hipótese envolvida está relacionada a um ambiente de baixo grau de inflamação crônica capaz de mediar tanto a ICC quanto o câncer (Ausoni and Azzarello, 2020;Bertero et al, 2019;Bertero et al, 2018 (Ausoni and Azzarello, 2020). Nesse sentido, vem sendo proposta a ideia de prevenção de câncer em pacientes com ICC, através da detecção de fenótipos cardio-inflamatórios (Ausoni and Azzarello, 2020).…”

“…A interconexão fisiopatológica entre as duas patologias, abre cada vez mais espaço para a busca por novas terapias farmacológicas capazes de atuar nas alterações metabólicas e inflamatórias tanto do câncer quanto da ICC, possivelmente contribuindo para a prevenção de processos neoplásicos em pacientes com doenças cardiovasculares pré-diagnosticadas (Ausoni and Azzarello, 2020). Por fim, uma abordagem focada na redução dos fatores de risco modificáveis entre ambas as doenças, torna-se essencial em pacientes acometidos com ICC na medida em que promove melhorias na qualidade de vida e reduz o risco de potenciais desenvolvimentos tumorais futuros (Cuomo et al, 2020).…”

Mechanism and prevention strategy of a bidirectional relationship between heart failure and cancer (Review)

“…At present, the mechanisms behind cardiac toxicity and treatment-associated effects are described in Fig. 1 and the following text ( 28 , 29 ).…”