Zhang Xin-Yu, Yang Ke-Lu, Li Yang, Zhao Yang, Jiang Ke-Wei, Wang Quan, Liu Xiao-Nan
Ambulatory Surgery Center, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
Nursing Department, Chengdu BOE Hospital, Chengdu, China.
Front Cardiovasc Med. 2022 Jun 29;9:921609. doi: 10.3389/fcvm.2022.921609. eCollection 2022.
Chemotherapy has significantly improved cancer survival rates at the cost of irreversible and frequent cardiovascular toxicity. As the main dose-dependent adverse effect, cardiotoxic effects not only limit the usage of chemotherapeutic agents, but also cause the high risk of severe poor prognoses for cancer survivors. Therefore, it is of great significance to seek more effective cardioprotective strategies. Some nutrients have been reported to diminish cardiac oxidative damage associated with chemotherapy. However, the currently available evidence is unclear, which requires a rigorous summary. As such, we conducted a systematic review of all available evidence and demonstrated whether nutrients derived from food could prevent cardiotoxicity caused by chemotherapy.
We searched Medline (via PubMed), Embase and the Cochrane Library from inception to Nov 9, 2021 to identify studies reporting dietary nutrients against cancer chemotherapy-related cardiotoxicity. We performed descriptive summaries on the included studies, and used forest plots to demonstrate the effects of various dietary nutrients.
Fifty-seven eligible studies were identified, involving 53 animal studies carried on rats or mice and four human studies in cancer patients. Seven types of dietary nutrients were recognized including polyphenols (mainly extracted from grapes, grape seeds, and tea), allicin (mainly extracted form garlic), lycopene (mainly extracted from tomatoes), polyunsaturated fatty acids, amino acids (mainly referring to glutamine), coenzyme Q10, and trace elements (mainly referring to zinc and selenium). Dietary nutrients ameliorated left ventricular dysfunctions and myocardial oxidative stress at varying degrees, which were caused by chemotherapy. The overall risk of bias of included studies was at moderate to high risk.
The results indicated that dietary nutrients might be a potential strategy to protect cardiovascular system exposed to the chemotherapeutic agents, but more human studies are urged in this field. https://inplasy.com/inplasy-2022-3-0015/.
化疗显著提高了癌症生存率，但代价是不可逆转且频繁出现的心血管毒性。作为主要的剂量依赖性不良反应，心脏毒性不仅限制了化疗药物的使用，还导致癌症幸存者出现严重不良预后的高风险。因此，寻求更有效的心脏保护策略具有重要意义。据报道，一些营养素可减轻与化疗相关的心脏氧化损伤。然而，目前可得的证据尚不明确，这需要进行严谨的总结。因此，我们对所有可得证据进行了系统综述，以证明食物来源的营养素是否能预防化疗引起的心脏毒性。
我们检索了从创刊至2021年11月9日的Medline（通过PubMed）、Embase和Cochrane图书馆，以识别报告饮食营养素预防癌症化疗相关心脏毒性的研究。我们对纳入的研究进行了描述性总结，并使用森林图展示各种饮食营养素的效果。
共识别出57项符合条件的研究，其中包括53项在大鼠或小鼠上进行的动物研究以及4项针对癌症患者的人体研究。识别出七种饮食营养素，包括多酚（主要从葡萄、葡萄籽和茶叶中提取）、大蒜素（主要从大蒜中提取）、番茄红素（主要从番茄中提取）、多不饱和脂肪酸、氨基酸（主要指谷氨酰胺）、辅酶Q10和微量元素（主要指锌和硒）。饮食营养素不同程度地改善了化疗引起的左心室功能障碍和心肌氧化应激。纳入研究的总体偏倚风险为中到高风险。
结果表明，饮食营养素可能是保护暴露于化疗药物的心血管系统的潜在策略，但该领域迫切需要更多人体研究。https://inplasy.com/inplasy-2022-3-0015/
