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Clinical Updates on Cardiac and Vascular Toxicities from Antineoplastic Drugs...
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Clinical Updates on Cardiac and Vascular Toxicities from Antineoplastic Drugs and Beyond

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 2276

Special Issue Editor

Prof. Dr. Rosalinda Madonna

E-Mail Website
Guest Editor
Department of Pathology, University of Pisa, 56124 Pisa, Italy
Interests: cardio-oncology; heart failure; pulmonary hypertension; ischemia/reperfusion injury; cell therapy and cardiac stem cells
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With the improvement in cancer prognosis due to advances in antitumor therapeutic protocols and new targeted and immunotherapies, we are witnessing a growing increase in survival; however, at the same time, an increase in morbidity among cancer survivors as a consequence of the increased cardiovascular adverse effects of antineoplastic drugs has also been observed. Common cardiac and vascular complications of antineoplastic therapies may include arrhythmias, myocardial ischemia, and left ventricular dysfunction culminating in heart failure, as well as vascular complications with arterial hypertension, thromboembolic events, and accelerated atherosclerosis. In this Special Issue, we welcome authors to submit papers on clinical aspects in terms of prognosis, diagnosis, and treatment, as well as the novel mechanisms that are implicated in antineoplastic drug-induced cardiac and vascular toxicity.

Prof. Dr. Rosalinda Madonna
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiotoxicity
  • vascular toxicity
  • cardio-oncology
  • immune checkpoint inhibitors
  • anthracyclines
  • tyrosine kinase inhibitors
  • HER2
  • proteasome inhibitors
  • platinum
  • antimetabolites
  • microtubule inhibitors

Published Papers (3 papers)

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Research

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13 pages, 259 KiB  
Article
Echocardiographic Assessment of Left Ventricular Function in Three Oncologic Therapeutic Modalities in Women with Breast Cancer: The ONCO-ECHO Multicenter Study
by Tomasz Gąsior, Beata Zaborska, Paweł Stachowiak, Małgorzata Sikora-Frąc, Katarzyna Mizia-Stec, Jarosław Kasprzak, Artur Bodys, Julia Bijoch, Adrianna Szmagała, Dariusz A. Kosior and Edyta Płońska-Gościniak
J. Clin. Med. 2024, 13(9), 2543; https://doi.org/10.3390/jcm13092543 - 26 Apr 2024
Viewed by 218
Abstract
Background: Oncological treatment of breast cancer may be associated with adverse effects on myocardial function. Objectives: The objective of this study was to compare the influence of three oncological treatment methods of intervention on the echocardiographic (ECHO) parameters of left ventricular [...] Read more.
Background: Oncological treatment of breast cancer may be associated with adverse effects on myocardial function. Objectives: The objective of this study was to compare the influence of three oncological treatment methods of intervention on the echocardiographic (ECHO) parameters of left ventricular function. Materials and Methods: One hundred and fifty-five women with breast cancer were divided into three groups depending on the type of therapy used: group I (AC)—anthracyclines; group II (AC + TZ)—anthracyclines + trastuzumab; and group III (RTls+)—anthracyclines with or without trastuzumab + left-sided radiotherapy. Prospective ECHO examinations were performed at baseline and every 3 months, up to 12 months from the start of the therapy. Patients with a history of chemotherapy or who were diagnosed with heart disease were not included in the study. Results: Out of 155 patients, 3 died due to cancer as the primary cause, and 12 withdrew their consent for further observation. Baseline systolic and diastolic ECHO parameters did not differ between the analyzed groups. Cardiotoxicity, according to the LVEF criteria, occurred during follow-up in 20 patients (14.3%), irrespective of the treatment method used. Diastolic echocardiographic parameters did not change significantly after 12 months in each group, except for the left atrial volume index (LAVi), which was significantly higher in the AC + TZ compared to the values in the RTls+ group. Conclusions: All three oncologic therapeutic modalities in women with breast cancer showed no significant differences in relation to the incidence of echocardiographic cardiotoxicity criterion; however, transient systolic decrease in LVEF was most frequently observed in the AC + TZ therapeutic regimen. Left-sided radiotherapy was not associated with excess left ventricular systolic and diastolic dysfunction during a 12-month follow-up period. The predictors of negative changes in diastolic parameters included age and combined anthracycline and trastuzumab therapy. Full article
(This article belongs to the Special Issue Clinical Updates on Cardiac and Vascular Toxicities from Antineoplastic Drugs and Beyond)
13 pages, 627 KiB  
Article
Atrial Strain Assessment for the Early Detection of Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer Women (The STRANO STUDY: Atrial Strain in Cardio-Oncology)
by Daniela Di Lisi, Antonella Moreo, Grazia Casavecchia, Christian Cadeddu Dessalvi, Corinna Bergamini, Concetta Zito, Cristina Madaudo, Rosalinda Madonna, Matteo Cameli and Giuseppina Novo
J. Clin. Med. 2023, 12(22), 7127; https://doi.org/10.3390/jcm12227127 - 16 Nov 2023
Cited by 1 | Viewed by 991
Abstract
Left ventricular global longitudinal strain (GLS) has an important role in the diagnosis of cancer therapy-related cardiac dysfunction (CTRCD). Little is known about the role of atrial function in diagnosing CTRCD. The aim of our study was to assess the impact of anti-cancer [...] Read more.
Left ventricular global longitudinal strain (GLS) has an important role in the diagnosis of cancer therapy-related cardiac dysfunction (CTRCD). Little is known about the role of atrial function in diagnosing CTRCD. The aim of our study was to assess the impact of anti-cancer drugs on atrial function measured by speckle-tracking echocardiography in breast cancer women. A prospective multicenter study was conducted enrolling 169 breast cancer women treated with anthracyclines. A cardiological evaluation including an electrocardiogram and echocardiogram with an analysis of GLS, left atrial (LA) strain, and LA stiffness (LASi) was performed at baseline (T0), 3 (T1), and 6 months (T2) after starting chemotherapy. The patients were divided into two groups: patients with asymptomatic mild cardiotoxicity at T1 (with a relative reduction in GLS > 15%; Group 1) and those without (Group 2). We did not find a significant change in left ventricular ejection fraction (LVEF) at T1 and T2; we found a significant change in GLS (p-value < 0.0001) in the peak atrial longitudinal strain (PALS) and in LASi (p-value < 0.0001). Impairment of atrial function was greater in Group 1 compared to Group 2. A PALS variation > 20.8% identified patients who were most likely to develop asymptomatic mild cardiotoxicity [AUC 0.62; CI (0.51–0.73) p = 0.06, sensitivity 45%, specificity 69.5%]. Conclusions: PALS and LASi significantly change during chemotherapy in association with GLS. Atrial strain is an additional parameter that could be measured together with GLS to detect cardiotoxicity early. Full article
(This article belongs to the Special Issue Clinical Updates on Cardiac and Vascular Toxicities from Antineoplastic Drugs and Beyond)
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Review

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30 pages, 1432 KiB  
Review
Cardiovascular Toxicity of Antineoplastic Treatments in Hematological Diseases: Focus on Molecular Mechanisms to Improve Therapeutic Management
by Serena Barachini, Gabriele Buda and Iacopo Petrini
J. Clin. Med. 2024, 13(6), 1574; https://doi.org/10.3390/jcm13061574 - 09 Mar 2024
Viewed by 844
Abstract
In recent years, advancements in the treatment of hematologic neoplasms have led to more effective and less toxic therapeutic schemes, resulting in prolonged patient life expectancy. However, the success of these treatments has also brought about an increased prevalence of cardiovascular adverse events, [...] Read more.
In recent years, advancements in the treatment of hematologic neoplasms have led to more effective and less toxic therapeutic schemes, resulting in prolonged patient life expectancy. However, the success of these treatments has also brought about an increased prevalence of cardiovascular adverse events, becoming a significant concern for the growing population of cancer survivors. Antineoplastic therapies, targeting both tumor and organ vessels, contribute to vascular toxicity, influenced by genetic factors and pre-existing vascular diseases. Chemotherapeutic agents and targeted treatments can induce cardiovascular toxicity by affecting endothelial cells and cardiomyocytes through various mechanisms, including hypoxia, vasculature abnormalities, and direct effects on cardiomyocytes. Cardiovascular adverse events encompass a wide range, from cardiac dysfunction to an elevated risk of arrhythmias. While early cardiac events are well-described in clinical trials, delayed toxicities are gaining relevance due to prolonged patient survival. The review focuses on the cardiac and vascular toxicity of antineoplastic drugs in hematological disorders, providing insights into the molecular physiopathology of cancer therapy-associated cardiotoxicity. Understanding how these drugs interact with the heart and blood vessels is essential for predicting, detecting, and managing chemotherapy-related heart issues. Full article
(This article belongs to the Special Issue Clinical Updates on Cardiac and Vascular Toxicities from Antineoplastic Drugs and Beyond)
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