Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
Life Sci. 2024 Dec 1;358:123170. doi: 10.1016/j.lfs.2024.123170. Epub 2024 Oct 26.
This review aims to elucidate the bidirectional relationship between heart failure and cancer by identifying their common and reciprocal risk factors. It seeks to provide a comprehensive understanding of the mechanistic interactions between these two conditions, supported by evidence from preclinical and clinical investigations.
A thorough review of peer-reviewed articles was conducted to identify all possible interactions between cancer and heart failure. Multiple search engines were utilized with queries incorporating terms such as cardio-oncology, heart failure, cancer, risk factors, and mechanistic interactions. Selected studies were analysed to identify shared risk factors and to explore the mechanistic junctions that link the two diseases.
The review identified several common risk factors, including, inflammation, smoking, obesity, clonal haematopoiesis of indeterminate potential, and reduced exercise potential. The pathophysiological mechanisms linking heart failure with cancer include metabolic reprogramming in cancer, cancer-induced thrombosis, cardiac metastasis, paraneoplastic syndrome, cancer-associated cachexia, and anorexia. Additionally, it was found that cancer therapies, such as anthracyclines and radiation, can induce cardiotoxicity, leading to heart failure. The pathophysiological mechanisms that contribute to cancer in heart failure patients were identified as neurohormonal activation, state of hypoxia, secretion of Cardiokines, heart failure medication, innate immune reprograming & cardiac remodelling and coronary atherosclerotic disease.
By highlighting the interconnected nature of heart failure and cancer, this review promotes a cardio-oncologic discourse, encouraging cardiologists and oncologists to consider these diseases as interrelated rather than separate entities. This perspective can lead to the development of novel therapeutic strategies and improve patient management by addressing the dual disease burden. Future research should focus on exploring the translational potential of existing drugs and developing new interventions to target the shared characteristics of heart failure and cancer.
本综述旨在通过确定心力衰竭和癌症的共同和相互的危险因素，阐明它们之间的双向关系。它旨在通过临床前和临床研究的证据，提供对这两种情况之间的机制相互作用的全面理解。
对同行评议的文章进行了全面审查，以确定癌症和心力衰竭之间的所有可能相互作用。使用多个搜索引擎，查询中包含了心脏肿瘤学、心力衰竭、癌症、危险因素和机制相互作用等术语。对选定的研究进行了分析，以确定共同的危险因素，并探讨将这两种疾病联系起来的机制连接点。
该综述确定了几个共同的危险因素，包括炎症、吸烟、肥胖、不确定潜能的克隆性造血和运动能力下降。将心力衰竭与癌症联系起来的病理生理机制包括癌症中的代谢重编程、癌症引起的血栓形成、心脏转移、副肿瘤综合征、癌症相关恶病质和厌食症。此外，还发现癌症治疗，如蒽环类药物和放疗，可导致心脏毒性，进而导致心力衰竭。导致心力衰竭患者发生癌症的病理生理机制被确定为神经激素激活、缺氧状态、心脏因子分泌、心力衰竭药物、固有免疫重编程和心脏重塑以及冠状动脉粥样硬化性疾病。
通过强调心力衰竭和癌症之间的相互联系，本综述促进了心脏肿瘤学的讨论，鼓励心脏病专家和肿瘤学家将这些疾病视为相互关联的，而不是独立的实体。这种观点可以通过针对心力衰竭和癌症的共同特征来开发新的治疗策略并改善患者管理，从而改善患者管理。未来的研究应侧重于探索现有药物的转化潜力并开发新的干预措施，以靶向心力衰竭和癌症的共同特征。
