Chianca Michela, Panichella Giorgia, Fabiani Iacopo, Giannoni Alberto, L'Abbate Serena, Aimo Alberto, Del Franco Annamaria, Vergaro Giuseppe, Grigoratos Chrysanthos, Castiglione Vincenzo, Cipolla Carlo Maria, Fedele Antonella, Passino Claudio, Emdin Michele, Cardinale Daniela Maria
Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
Front Cardiovasc Med. 2022 Jul 6;9:936654. doi: 10.3389/fcvm.2022.936654. eCollection 2022.
Cancer and heart failure are the two leading causes of death in developed countries. These two apparently distinct clinical entities share similar risk factors, symptoms, and pathophysiological mechanisms (inflammation, metabolic disturbances, neuro-hormonal and immune system activation, and endothelial dysfunction). Beyond the well-known cardiotoxic effects of oncological therapies, cancer and heart failure are thought to be tied by a bidirectional relationship, where one disease favors the other and vice versa. In this context, biomarkers represent a simple, reproducible, sensitive and cost-effective method to explore such relationship. In this review, we recapitulate the evidence on cardiovascular and oncological biomarkers in the field of cardioncology, focusing on their role in treatment-naïve cancer patients. Cardioncological biomarkers are useful tools in risk stratification, early detection of cardiotoxicity, follow-up, and prognostic assessment. Intriguingly, these biomarkers might contribute to better understand the common pathophysiology of cancer and heart failure, thus allowing the implementation of preventive and treatment strategies in cardioncological patients.
癌症和心力衰竭是发达国家的两大主要死因。这两种明显不同的临床实体具有相似的危险因素、症状和病理生理机制（炎症、代谢紊乱、神经激素和免疫系统激活以及内皮功能障碍）。除了肿瘤治疗众所周知的心脏毒性作用外，癌症和心力衰竭被认为通过双向关系相互关联，即一种疾病会促进另一种疾病的发展，反之亦然。在这种背景下，生物标志物是探索这种关系的一种简单、可重复、敏感且具有成本效益的方法。在这篇综述中，我们总结了心脏肿瘤学领域中心血管和肿瘤生物标志物的证据，重点关注它们在未接受过治疗的癌症患者中的作用。心脏肿瘤学生物标志物是风险分层、心脏毒性早期检测、随访和预后评估的有用工具。有趣的是，这些生物标志物可能有助于更好地理解癌症和心力衰竭的共同病理生理学，从而在心脏肿瘤学患者中实施预防和治疗策略。
