Cardiac Cachexia: Unaddressed Aspect in Cancer Patients.
Sarama SahaPraveen Kumar SinghPartha RoySham S KakarPublished in: Cells (2022)
Tumor-derived cachectic factors such as proinflammatory cytokines and neuromodulators not only affect skeletal muscle but also affect other organs, including the heart, in the form of cardiac muscle atrophy, fibrosis, and eventual cardiac dysfunction, resulting in poor quality of life and reduced survival. This article reviews the holistic approaches of existing diagnostic, pathophysiological, and multimodal therapeutic interventions targeting the molecular mechanisms that are responsible for cancer-induced cardiac cachexia. The major drivers of cardiac muscle wasting in cancer patients are autophagy activation by the cytokine-NFkB, TGF β-SMAD 3 , and angiotensin II-SOCE-STIM-Ca 2+ pathways. A lack of diagnostic markers and standard treatment protocols hinder the early diagnosis of cardiac dysfunction and the initiation of preventive measures. However, some novel therapeutic strategies, including the use of Withaferin A, have shown promising results in experimental models, but Withaferin A's effectiveness in human remains to be verified. The combined efforts of cardiologists and oncologists would help to identify cost effective and feasible solutions to restore cardiac function and to increase the survival potential of cancer patients.
Keyphrases
- skeletal muscle
- left ventricular
- angiotensin ii
- randomized controlled trial
- transforming growth factor
- heart failure
- systematic review
- endothelial cells
- squamous cell carcinoma
- epithelial mesenchymal transition
- metabolic syndrome
- adipose tissue
- physical activity
- type diabetes
- cancer therapy
- quality improvement
- palliative care
- stress induced
- climate change
- atrial fibrillation
- advanced cancer
- squamous cell