Cardiac Injury Following Chemo/Radiation Therapy: An Updated Review on Mechanisms and Therapeutic Approaches.
Krishanveer SinghAmeer A AlameriAmmar Ali HamzaMoaed E Al-GazallySarvar Temurovich IslomovRasha Fadhel ObaidAndrés Alexis Ramírez-CoronelMunther AbosaoodaRasoul YahyapourMasoud NajafiPublished in: Current radiopharmaceuticals (2023)
Cardiovascular disorders are among the critical side effects of cancer therapy. Damage to the function and normal structure of the heart can cause serious threats to patients that are being treated for cancer. Cardiovascular complications may be induced by various types of chemotherapy drugs and also radiation therapy. The severity of cardiovascular toxicity depends on several factors, such as types of drugs, tumor location for radiotherapy, the presence of cardiac disease history, the dose of drugs or ionizing radiation, etc. Radiotherapy and chemotherapy can cause heart diseases through various mechanisms, such as oxidative stress, inflammation, cell death, fibrosis, endothelial to mesenchymal transition (EndMT), etc. Chronic inflammation following damage to a huge number of cells can trigger more accumulation of inflammatory cells and chronic release of reactive oxygen species (ROS) and nitric oxide (NO). Oxidative stress can induce more cell death and cardiac remodeling through damage to vessels and valvular and disruption of the normal structure of the extracellular matrix. These changes may lead to cardiomyopathy, myocarditis, pericarditis, and vascular disorders that may lead to heart attack and death. This review provides basic information on cellular and molecular mechanisms of different types of cardiovascular disorders following cancer therapy by radiation or chemotherapy. We also recommend some adjuvants and targets to reduce the risk of heart toxicity by radiation/chemotherapy.
Keyphrases
- oxidative stress
- locally advanced
- induced apoptosis
- radiation therapy
- cell death
- cancer therapy
- cell cycle arrest
- rectal cancer
- heart failure
- dna damage
- extracellular matrix
- squamous cell carcinoma
- reactive oxygen species
- radiation induced
- atrial fibrillation
- diabetic rats
- nitric oxide
- ischemia reperfusion injury
- left ventricular
- drug delivery
- end stage renal disease
- newly diagnosed
- early stage
- ejection fraction
- stem cells
- risk factors
- photodynamic therapy
- bone marrow
- chronic kidney disease
- nitric oxide synthase
- endoplasmic reticulum stress
- signaling pathway
- heat shock
- hydrogen peroxide
- combination therapy
- childhood cancer
- squamous cell