Zheng Yawen, Chen Han, Li Xiaoqing, Sun Yuping
Department of Oncology, Jinan Central Hospital, Shandong University, No. 105, Jie Fang Road, Jinan, Shandong, 250013, People's Republic of China.
Soochow University College of Medicine, Suzhou, Jiangsu, 215000, China.
Support Care Cancer. 2016 Jul;24(7):3253-9. doi: 10.1007/s00520-016-3222-2. Epub 2016 Apr 23.
Cancer cachexia is a complex and multifaceted disease state characterized by fatigue, weakness, and loss of skeletal muscle and adipose tissue. Recently, the profound negative effects of cancer cachexia on cardiac tissue draw much attention, which is likely to contribute to mortality in tumor-bearing animals. The mechanism of cardiac remodeling is not so clear and involved with a series of molecular alterations. In cancer cachexia model, progressive loss of left ventricular mass and decrease in myocardial function is observed and cardiac autonomic functions are altered. Levels of several emerging cardiovascular neurohormones are found elevating in patients with cancer, but it is still controversial whether the changes could reflect the heart injury accurately. The remedy for cardiac remodeling has been explored. It is showed that exercise can modulate signaling pathways activated by wasting cytokines and impact on the resulting outcomes on heart adaptation. Some drugs, such as bisoprolol, spironolactone, perindopril, tandospirone, and simvastatin, can mitigate adverse effects of the tumor on the heart and prolong survival.
癌症恶病质是一种复杂且多方面的疾病状态,其特征为疲劳、虚弱以及骨骼肌和脂肪组织的丢失。最近,癌症恶病质对心脏组织的严重负面影响备受关注,这可能导致荷瘤动物死亡。心脏重塑的机制尚不清楚,涉及一系列分子改变。在癌症恶病质模型中,观察到左心室质量逐渐减少、心肌功能下降以及心脏自主神经功能改变。在癌症患者中发现几种新出现的心血管神经激素水平升高,但这些变化是否能准确反映心脏损伤仍存在争议。人们已经探索了针对心脏重塑的治疗方法。结果表明,运动可以调节由消耗性细胞因子激活的信号通路,并影响心脏适应的最终结果。一些药物,如比索洛尔、螺内酯、培哚普利、坦度螺酮和辛伐他汀,可以减轻肿瘤对心脏的不良影响并延长生存期。