Jacc: Cardiooncology最新文献

{"title":"Rarefaction of Blood, But Not Lymphatic Capillaries, in Patients With Cardiac Amyloidosis","authors":"Alberto Aimo MD, PhD , Lucrezia Bonino MD , Vincenzo Castiglione MD , Veronica Musetti BSc , Martina Rossetti MD , Alessandra Celi MD , Michele Coceani MD , Michele Emdin MD, PhD , Angela Pucci MD, PhD , Giuseppe Vergaro MD, PhD","doi":"10.1016/j.jaccao.2024.07.009","DOIUrl":"10.1016/j.jaccao.2024.07.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 797-799"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic Dysfunction Among Adult Survivors of Childhood Cancer","authors":"Cezar A. Iliescu MD, Efstratios Koutroumpakis MD, Kaveh Karimzad MD","doi":"10.1016/j.jaccao.2024.09.004","DOIUrl":"10.1016/j.jaccao.2024.09.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 788-790"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthracycline Cardiotoxicity in Adult Cancer Patients","authors":"Massimiliano Camilli MD ,&nbsp;Carlo Maria Cipolla MD ,&nbsp;Susan Dent MD, BSc ,&nbsp;Giorgio Minotti MD, PhD ,&nbsp;Daniela Maria Cardinale MD, PhD","doi":"10.1016/j.jaccao.2024.07.016","DOIUrl":"10.1016/j.jaccao.2024.07.016","url":null,"abstract":"<div><div>Since their introduction in the 1960s, anthracyclines have been a significant breakthrough in oncology, introducing dramatic changes in the treatment of solid and hematologic malignancies. Although new-generation targeted drugs and cellular therapies are revolutionizing contemporary oncology, anthracyclines remain the cornerstone of treatment for lymphomas, acute leukemias, and soft tissue sarcomas. However, their clinical application is limited by a dose-dependent cardiotoxicity that can reduce cardiac performance and eventually lead to overt heart failure. The field of cardio-oncology has emerged to safeguard the cardiovascular health of cancer patients receiving these therapies. It focuses on controlling risk factors, implementing preventive strategies, ensuring appropriate surveillance, and managing complications. This state-of-the-art review summarizes the current indications for anthracyclines in modern oncology, explores recent evidence on pathophysiology and epidemiology, and discusses advances in cardioprotection measures in the anthracycline-treated patient. Additionally, it highlights key clinical challenges and research gaps in this area.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 655-677"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Troponin I and T in ICI Myocarditis Screening, Diagnosis, and Prognosis","authors":"Ana Barac MD, PhD ,&nbsp;Raymond C. Wadlow MD ,&nbsp;John F. Deeken MD ,&nbsp;Christopher deFilippi MD","doi":"10.1016/j.jaccao.2024.07.001","DOIUrl":"10.1016/j.jaccao.2024.07.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 804-807"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma","authors":"David Austin MBChB, MD ,&nbsp;Rebecca H. Maier MSc ,&nbsp;Nasima Akhter PhD ,&nbsp;Mohammad Sayari MSc ,&nbsp;Emmanuel Ogundimu PhD ,&nbsp;Jamie M. Maddox MBChB ,&nbsp;Sharareh Vahabi MBChB, MD ,&nbsp;Alison C. Humphreys MBBcH, MD ,&nbsp;Janine Graham MBChB ,&nbsp;Helen Oxenham MBChB, MD ,&nbsp;Sophie Haney MBBS ,&nbsp;Nicola Cresti MD, PhD ,&nbsp;Mark Verrill MB, BChir ,&nbsp;Wendy Osborne MBBS ,&nbsp;Kathryn L. Wright MBChB ,&nbsp;Rebecca Goranova MBBS ,&nbsp;James R. Bailey MBBS, PhD ,&nbsp;Nagesh Kalakonda MBBS, PhD ,&nbsp;Mac Macheta MBChB ,&nbsp;Mari F. Kilner MBChB ,&nbsp;Chris Plummer BM, BCh, PhD","doi":"10.1016/j.jaccao.2024.07.010","DOIUrl":"10.1016/j.jaccao.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Cardiotoxicity is a concern for cancer survivors undergoing anthracycline chemotherapy. Enalapril has been explored for its potential to mitigate cardiotoxicity in cancer patients. The dose-dependent cardiotoxicity effects of anthracyclines can be detected early through the biomarker cardiac troponin.</div></div><div><h3>Objectives</h3><div>The PROACT (Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma) clinical trial assessed the effectiveness of enalapril in preventing cardiotoxicity, manifesting as myocardial injury and cardiac function impairment, in patients undergoing high-dose anthracycline-based chemotherapy for breast cancer or non-Hodgkin lymphoma.</div></div><div><h3>Methods</h3><div>This prospective, multicenter, open-label, randomized controlled trial employed a superiority design with observer-blinded endpoints. A total of 111 participants, scheduled for 6 cycles of chemotherapy with a planned dose of ≥300 mg/m² doxorubicin equivalents, were randomized to receive either enalapril (titrated up to 20 mg daily) or standard care without enalapril.</div></div><div><h3>Results</h3><div>Myocardial injury, indicated by cardiac troponin T (≥14 ng/L), during and 1 month after chemotherapy, was observed in 42 (77.8%) of 54 patients in the enalapril group vs 45 (83.3%) of 54 patients in the standard care group (OR: 0.65; 95% CI: 0.23-1.78). Injury detected by cardiac troponin I (&gt;26.2 ng/L) occurred in 25 (47.2%) of 53 patients on enalapril compared with 24 (45.3%) of 53 in standard care (OR: 1.10; 95% CI: 0.50-2.38). A relative decline of more than 15% from baseline in left ventricular global longitudinal strain was observed in 10 (21.3%) of 47 patients on enalapril and 9 (21.9%) of 41 in standard care (OR: 0.95; 95% CI: 0.33-2.74). An absolute decline of &gt;10% to &lt;50% in left ventricular ejection fraction was seen in 2 (4.1%) of 49 patients on enalapril vs none in patients in standard care.</div></div><div><h3>Conclusions</h3><div>Adding enalapril to standard care during chemotherapy did not prevent cardiotoxicity in patients receiving high-dose anthracycline-based chemotherapy. (PROACT: Can we prevent Chemotherapy-related Heart Damage in Patients With Breast Cancer and Lymphoma?; <span><span>NCT03265574</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 684-696"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicohort Epigenome-Wide Association Study of All-Cause Cardiovascular Disease and Cancer Incidence","authors":"Arce Domingo-Relloso PhD ,&nbsp;Angela L. Riffo-Campos PhD ,&nbsp;Naisi Zhao DrPH ,&nbsp;Guillermo Ayala PhD ,&nbsp;Karin Haack PhD ,&nbsp;Carlos Manterola MD, PhD ,&nbsp;Dorothy A. Rhoades MD, MPH ,&nbsp;Jason G. Umans MD, PhD ,&nbsp;M Daniele Fallin PhD ,&nbsp;Miguel Herreros-Martinez MS ,&nbsp;Marina Pollan MD, PhD ,&nbsp;Eric Boerwinkle PhD ,&nbsp;Elizabeth A. Platz ScD, MPH ,&nbsp;Miranda R. Jones PhD ,&nbsp;Jan Bressler PhD ,&nbsp;Roby Joehanes PhD ,&nbsp;Calen P. Ryan PhD ,&nbsp;Juan R. Gonzalez PhD ,&nbsp;Daniel Levy MD ,&nbsp;Daniel W. Belsky PhD ,&nbsp;Maria Tellez-Plaza MD, PhD","doi":"10.1016/j.jaccao.2024.07.014","DOIUrl":"10.1016/j.jaccao.2024.07.014","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence reveals a complex relationship between cardiovascular disease (CVD) and cancer, which share common risk factors and biological pathways.</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate common epigenetic signatures for CVD and cancer incidence in 3 ethnically diverse cohorts: Native Americans from the SHS (Strong Heart Study), European Americans from the FHS (Framingham Heart Study), and European Americans and African Americans from the ARIC (Atherosclerosis Risk In Communities) study.</div></div><div><h3>Methods</h3><div>A 2-stage strategy was used that included first conducting untargeted epigenome-wide association studies for each cohort and then running targeted models in the union set of identified differentially methylated positions (DMPs). We also explored potential molecular pathways by conducting a bioinformatics analysis.</div></div><div><h3>Results</h3><div>Common DMPs were identified across all populations. In a subsequent meta-analysis, 3 and 1 of those DMPs were statistically significant for CVD only and both cancer and CVD, respectively. No meta-analyzed DMPs were statistically significant for cancer only. The enrichment analysis pointed to interconnected biological pathways involved in cancer and CVD. In the DrugBank database, elements related to 1-carbon metabolism and cancer and CVD medications were identified as potential drugs for target gene products. In an additional analysis restricted to the 950 SHS participants who developed incident CVD, the C index for incident cancer increased from 0.618 (95% CI: 0.570-0.672) to 0.971 (95% CI: 0.963-0.978) when adjusting the models for the combined cancer and CVD DMPs identified in the other cohorts.</div></div><div><h3>Conclusions</h3><div>These results point to molecular pathways and potential treatments for precision prevention of CVD and cancer. Screening based on common epigenetic signatures of incident CVD and cancer may help identify patients with newly diagnosed CVD at increased cancer risk.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 731-742"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study","authors":"John D. Groarke MBBCh, MPH ,&nbsp;Kirsten K. Ness PT, PhD ,&nbsp;Rikeenkumar Dhaduk ,&nbsp;Juan C. Plana MD ,&nbsp;Jean Bernard Durand MD ,&nbsp;Russell V. Luepker MD, MS ,&nbsp;Vijaya M. Joshi MD ,&nbsp;Matthew Ehrhardt MD ,&nbsp;Daniel A. Mulrooney MD ,&nbsp;Stephanie B. Dixon MD ,&nbsp;Anju Nohria MD ,&nbsp;Daniel M. Green MD ,&nbsp;Rebecca M. Howell PhD ,&nbsp;Deo Kumar Srivastava PhD ,&nbsp;John L. Jefferies MD, MPH ,&nbsp;Leslie L. Robison PhD ,&nbsp;Melissa M. Hudson MD ,&nbsp;Gregory T. Armstrong MD, MSCE","doi":"10.1016/j.jaccao.2024.08.005","DOIUrl":"10.1016/j.jaccao.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>The burden and functional significance of autonomic dysfunction among survivors of childhood cancer is unknown.</div></div><div><h3>Objectives</h3><div>We evaluated the prevalence, risk factors, and functional relevance of autonomic dysfunction in survivors.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional prospective evaluation of 1,041 adult survivors of childhood cancer treated with anthracyclines (31.1%), chest-directed radiation (13.5%), both (19.5%), or neither (35.9%), and 286 community control subjects enrolled in the SJLIFE (St Jude Lifetime Cohort Study). Four measures of autonomic dysfunction were evaluated: elevated resting heart rate, decreased heart rate reserve, decreased systolic blood pressure response to exercise, and delayed heart rate recovery. Logistic regression tested associations with impaired cardiorespiratory fitness (peak V<span>o</span>₂ &lt; 80% predicted).</div></div><div><h3>Results</h3><div>Survivors (50.7% female) were 9.0 ± 5.8 years at cancer diagnosis and 35.5 ± 8.9 years at evaluation. Prevalence (survivors vs control subjects) of elevated resting heart rate (17.9% vs 7.0%), decreased heart rate reserve (21.7% vs 9.1%), decreased systolic blood pressure response to exercise (25.3% vs 12.6%), and delayed heart rate recovery (24.3% vs 10.6%) was more than 2-fold higher among survivors (<em>P</em> &lt; 0.001 for all). Carboplatin (adjusted OR: 2.50; 95% CI: 1.42-4.40; <em>P</em> = 0.001), chest-directed radiation therapy (adjusted OR: 2.06; 95% CI: 1.52-2.75; <em>P</em> &lt; 0.001), and cranial radiation (adjusted OR: 1.49; 95% CI: 1.08-2.05; <em>P</em> = 0.015) were associated with an increased likelihood of having ≥2 measures of autonomic dysfunction. Survivors with ≥2 measures of autonomic dysfunction were at increased risk for impaired cardiorespiratory fitness (adjusted OR: 2.71; 95% CI: 1.82-4.02; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Survivors of childhood cancer manifest a higher prevalence of autonomic dysfunction associated with impaired cardiorespiratory fitness.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 775-787"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomics for Improving Heart Failure Risk Assessment in Cancer Patients","authors":"Sonia Shah PhD","doi":"10.1016/j.jaccao.2024.06.001","DOIUrl":"10.1016/j.jaccao.2024.06.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 728-730"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Dysfunction in Children and Young Adults Treated With MEK Inhibitors","authors":"Jonathan D. Bender MD, MS ,&nbsp;Natasha Pillay-Smiley DO ,&nbsp;Garick D. Hill MD, MS ,&nbsp;Peter de Blank MD, MSCE ,&nbsp;Trent R. Hummel MD ,&nbsp;Brian D. Weiss MD ,&nbsp;Ashish Kumar MD, PhD ,&nbsp;Huaiyu Zang PhD ,&nbsp;Nicholas J. Ollberding PhD ,&nbsp;Thomas D. Ryan MD, PhD","doi":"10.1016/j.jaccao.2024.07.004","DOIUrl":"10.1016/j.jaccao.2024.07.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 794-796"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Therapy and Exercise Intolerance: The Heart Is But a Part","authors":"","doi":"10.1016/j.jaccao.2024.04.006","DOIUrl":"10.1016/j.jaccao.2024.04.006","url":null,"abstract":"<div><p>The landscape of cancer therapeutics is continually evolving, with successes in improved survivorship and reduced disease progression for many patients with cancer. Improved cancer outcomes expose competing comorbidities, some of which may be exacerbated by cancer therapies. The leading cause of disability and death for many early-stage cancers is cardiovascular disease (CVD), which is often attributed to direct or indirect cardiac injury from cancer therapy. In this review, the authors propose that toxicities related to conventional and novel cancer therapeutics should be considered beyond the heart. The authors provide a framework using the oxygen pathway to understand the impact of cancer treatment on peak oxygen uptake, a marker of integrative cardiopulmonary function and CVD risk. Peripheral toxicities and the impact on oxygen transport are discussed. Consideration for the broad effects of cancer therapies will improve the prediction and identification of cancer survivors at risk for CVD, functional disability, and premature mortality and those who would benefit from therapeutic intervention, ultimately improving patient outcomes.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 4","pages":"Pages 496-513"},"PeriodicalIF":12.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001510/pdfft?md5=ef3ce0717a05b360787f0aae64a19422&pid=1-s2.0-S2666087324001510-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}