Perioperative complications in patients with anthracycline chemotherapeutic agents

Burrows, Frederick A.; Hickey, Paul R.; Colan, Steven D.

doi:10.1007/bf03010041

Cited by 33 publications

(6 citation statements)

References 13 publications

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“…Hypotension is also a top perioperative cardiovascular complication in the patients with a history of anthracycline drug therapy, which was associated with or without depressed LV function (97). DOX enhances secretion of vasoactive substances such as histamine although the release of vasoactive substances may not play a prevalent role in the development of DOX cardiotoxicity (98).…”

Section: Concerns and Precautions On Potential Adverse Effectsmentioning

confidence: 99%

Dietary inorganic nitrate alleviates doxorubicin cardiotoxicity: Mechanisms and implications

Zhu

Das

et al. 2012

Nitric Oxide

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Doxorubicin (DOX) is one of the most powerful and widely prescribed chemotherapeutic agents to treat divergent human cancers. However, the clinical use of DOX is restricted due to its severe cardiotoxic side-effects. There has been ongoing search for cardioprotectants against DOX toxicity. Inorganic nitrate has emerged as a bioactive compound that can be reduced into nitrite and nitric oxide in vivo and in turn plays a therapeutic role in diseases associated with nitric oxide insufficiency or dysregulation. In this review, we describe a novel concept of using dietary supplementation of inorganic nitrate to reduce DOX-induced cardiac cellular damage and dysfunction, based on our recent promising studies in a mouse model of DOX cardiotoxicity. Our data show that chronic oral ingestion of sodium nitrate, at a dose equivalent to ~400% of the Acceptable Daily Intake of the World Health Organization, alleviated DOX-induced left ventricular dysfunction and mitochondrial respiratory chain damage. Such cardioprotective effects were associated with reduction of cardiomyocyte necrosis/apoptosis, tissue lipid peroxidation, and mitochondrial H2O2 generation following DOX treatment. Furthermore, proteomic studies revealed enhanced cardiac expression of mitochondrial antioxidant enzyme – peroxiredoxin 5 in the nitrate-treated animals. These studies suggest that inorganic nitrate could be an inexpensive therapeutic agent for long-term oral administration in preventing DOX-induced cardiac toxicity and myopathy during the prolonged pathological process. Future clinical trials in the cancer patients undergoing DOX chemotherapy are warranted to translate these experimental findings into an effective new therapy in preventing the DOX-induced cardiomyopathy.

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Section: Concerns and Precautions On Potential Adverse Effectsmentioning

confidence: 99%

Dietary inorganic nitrate alleviates doxorubicin cardiotoxicity: Mechanisms and implications

Zhu

Das

et al. 2012

Nitric Oxide

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“…Despite attempts to reduce cardiotoxicity by limiting the cumulative dose, abnormalities in cardiac structure and function were noted in 65% of survivors of childhood acute lymphoblastic leukaemia 6 years after completed anthracycline therapy [14]. In this population, early congestive heart failure is the strongest risk factor for peri-operative cardiovascular complications with subsequent surgical procedures [15]. Recently, it has been shown that, in survivors of childhood cancer, subtle abnormalities in cardiac function may exist, even in patients with normal resting cardiac function, which become apparent only after exercise.…”

Section: Cardiac Toxicitymentioning

confidence: 99%

“…In this study, induction techniques comprised inhalation of halothane and intravenous application of thiopentone, diazepam, and ketamine, and maintenance technique comprised halothane, enflurane, and N 2 O. However, no particular anaesthetic technique could be identified as a risk factor [15]. (Fig.…”

Section: Clinical Experiencementioning

confidence: 99%

Anaesthesia and anti-cancer chemotherapeutic drugs

Huettemann

Sakka

2005

Current Opinion in Anaesthesiology

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“…In a study of 111 patients 0.5–22 years of age undergoing anesthesia, seven patients (6.3%) experienced hypotension, of which two cases were identified to be of cardiac etiology. Both of these patients had pre‐operative signs of heart failure (54). Huettemann et al.…”

Section: Heartmentioning

confidence: 99%

Anesthetic considerations for the pediatric oncology patient – part 2: systems‐based approach to anesthesia

Latham

Greenberg

2010

Pediatric Anesthesia

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One of the prices paid for chemo- and radiotherapy of cancer in children is damage to the vulnerable and developing healthy tissues of the body. Such damage can exist clinically or subclinically and can become apparent during active antineoplastic treatment or during remission decades later. Furthermore, effects of the tumor itself can significantly impact the physiologic state of the child. The anesthesiologist who cares for children with cancer or for survivors of childhood cancer should understand what effects cancer and its therapy can have on various organ systems. In part two of this three-part review, we review the anesthetic issues associated with childhood cancer. Specifically, this review presents a systems-based approach to the impact from both tumor and its treatment in children, followed by a discussion of the relevant anesthetic considerations.

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Perioperative complications in patients with anthracycline chemotherapeutic agents

Cited by 33 publications

References 13 publications

Dietary inorganic nitrate alleviates doxorubicin cardiotoxicity: Mechanisms and implications

Dietary inorganic nitrate alleviates doxorubicin cardiotoxicity: Mechanisms and implications

Anaesthesia and anti-cancer chemotherapeutic drugs

Anesthetic considerations for the pediatric oncology patient – part 2: systems‐based approach to anesthesia

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