Newman Alexandra A C, Dalman Jessie M, Moore Kathryn J
Cardiovascular Research Center, New York University Langone Health (A.A.C.N., J.M.D., K.J.M.).
Leon H. Charney Division of Cardiology, Department of Medicine (A.A.C.N., J.M.D., K.J.M.), New York University Grossman School of Medicine.
Arterioscler Thromb Vasc Biol. 2025 Mar;45(3):359-371. doi: 10.1161/ATVBAHA.124.319863. Epub 2025 Jan 9.
The field of cardio-oncology has traditionally focused on the impact of cancer and its therapies on cardiovascular health. Mounting clinical and preclinical evidence, however, indicates that the reverse may also be true: cardiovascular disease can itself influence tumor growth and metastasis. Numerous epidemiological studies have reported that individuals with prevalent cardiovascular disease have an increased incidence of cancer. In parallel, studies using preclinical mouse models of myocardial infarction, heart failure, and cardiac remodeling support the notion that cardiovascular disorders accelerate the growth of solid tumors and metastases. These findings have ushered in a new and burgeoning field termed reverse cardio-oncology that investigates the impact of cardiovascular disease pathophysiology on cancer emergence and progression. Recent studies have begun to illuminate the mechanisms driving this relationship, including shared risk factors, reprogramming of immune responses, changes in gene expression, and the release of cardiac factors that result in selective advantages for tumor cells or their local milieu, thus exacerbating cancer pathology. Here, we review the evidence supporting the relationship between cardiovascular disease and cancer, the mechanistic pathways enabling this connection, and the implications of these findings for patient care.
传统上，心脏肿瘤学领域主要关注癌症及其治疗方法对心血管健康的影响。然而，越来越多的临床和临床前证据表明，反之亦然：心血管疾病本身可能影响肿瘤的生长和转移。大量流行病学研究报告称，患有心血管疾病的个体患癌症的几率更高。与此同时，使用心肌梗死、心力衰竭和心脏重塑的临床前小鼠模型进行的研究支持了心血管疾病会加速实体肿瘤生长和转移这一观点。这些发现开创了一个新的、蓬勃发展的领域，即逆向心脏肿瘤学，该领域研究心血管疾病病理生理学对癌症发生和进展的影响。最近的研究已经开始阐明驱动这种关系的机制，包括共同的风险因素、免疫反应的重新编程、基因表达的变化以及心脏因子的释放，这些因素导致肿瘤细胞或其局部环境具有选择性优势，从而加剧癌症病理。在此，我们综述了支持心血管疾病与癌症之间关系的证据、促成这种联系的机制途径以及这些发现对患者护理的意义。
