Cardiotoxicity and cancer therapy

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Cardiotoxicity and cancer therapy

Vasiliadis, I; Kolovou, G; Mikhailidis, DP; (2014) Cardiotoxicity and cancer therapy. Angiology , 65 (5) 369 - 371. 10.1177/0003319713498298. Green open access

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Abstract

A fundamental concept of treatment is to do no harm. However, with cancer treatment this is not always possible. Chemotherapy is associated with cardiovascular (CV) complications.1,2 This risk is even greater in the elderly patients and patients with established CV disease. More specifically, tachyarrhythmias (eg, cisplatin), bradyarrythmias (eg, paclitaxel), or QT prolongation (eg, dasatinib) have been reported. Furthermore, myocardial necrosis, coronary vaso-occlusion or vasospasm, pericardial disease (eg, cytarabine), endocardial fibrosis (eg, busulfan), and heart failure can occur. Hypotension (eg, fludarabine) or hypertension (eg, vinca alkaloids) has also been reported.1,2 Cardiotoxicity, endothelial injury, and Takotsubo syndrome have been reported in patients treated with 5-fluorouracil (5-FU).3⇓–5 Cardiotoxicity to 5-FU was reported 35 years ago.3⇓–5 Cardiotoxicity of chemotherapy has been reported in patients ranging from children through adults (eg, with anthracyclines or cisplatin).6 Adriamycin-induced myocyte damage has been attributed to the production of toxic oxygen free radicals.7 This can cause lipid peroxidation of membranes resulting in vacuolation, irreversible damage, and myocyte replacement by fibrous tissue.7 The use of angiogenesis inhibitors in cancer therapy is expanding as are the associated adverse CV effects (eg, hypertension, thromboembolism, left ventricular dysfunction, and QTc prolongation).2,8 Vascular endothelial growth factor (VEGF) plays a role in maintaining vascular homeostasis via the production of the vasodilator nitric oxide (NO) and decreased vascular resistance through the generation of new blood vessels.2,8 Therefore, it is not surprising that inhibition of VEGF signaling (eg, … [Full Text of this Article]

Type:	Article
Title:	Cardiotoxicity and cancer therapy
Location:	United States
Open access status:	An open access version is available from UCL Discovery
DOI:	10.1177/0003319713498298
Publisher version:	http://dx.doi.org/10.1177/0003319713498298
Language:	English
Additional information:	This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/), which permits use, distribution, and reproduction in any medium, provided that that reuse is restricted to non-commercial purposes, i.e. research or educational use, and the original work is properly cited.
Keywords:	Angiogenesis Inhibitors, Antineoplastic Agents, Antineoplastic Agents, Hormonal, Arrhythmias, Cardiac, Cardiovascular Diseases, Cardiovascular System, Carotid Stenosis, Coronary Disease, Fibrosis, Heart, Heart Conduction System, Heart Diseases, Humans, Myocardium, Neoplasms, Practice Guidelines as Topic, Radiotherapy, Risk Factors, Thromboembolism, Time Factors, Vascular Stiffness
UCL classification:	UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
URI:	https://discovery.ucl.ac.uk/id/eprint/1469510