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Kaur N, Sharma RK, Singh Kushwah A, Singh N, Thakur S. A Comprehensive Review of Dilated Cardiomyopathy in Pre-clinical Animal Models in Addition to Herbal Treatment Options and Multi-modality Imaging Strategies. Cardiovasc Hematol Disord Drug Targets 2023; 22:207-225. [PMID: 36734898 DOI: 10.2174/1871529x23666230123122808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/05/2022] [Accepted: 11/17/2022] [Indexed: 02/01/2023]
Abstract
Dilated cardiomyopathy (DCM) is distinguished by ventricular chamber expansion, systolic dysfunction, and normal left ventricular (LV) wall thickness, and is mainly caused due to genetic or environmental factors; however, its aetiology is undetermined in the majority of patients. The focus of this work is on pathogenesis, small animal models, as well as the herbal medicinal approach, and the most recent advances in imaging modalities for patients with dilated cardiomyopathy. Several small animal models have been proposed over the last few years to mimic various pathomechanisms that contribute to dilated cardiomyopathy. Surgical procedures, gene mutations, and drug therapies are all characteristic features of these models. The pros and cons, including heart failure stimulation of extensively established small animal models for dilated cardiomyopathy, are illustrated, as these models tend to procure key insights and contribute to the development of innovative treatment techniques for patients. Traditional medicinal plants used as treatment in these models are also discussed, along with contemporary developments in herbal therapies. In the last few decades, accurate diagnosis, proper recognition of the underlying disease, specific risk stratification, and forecasting of clinical outcome, have indeed improved the health of DCM patients. Cardiac magnetic resonance (CMR) is the bullion criterion for assessing ventricular volume and ejection fraction in a reliable and consistent direction. Other technologies, like strain analysis and 3D echocardiography, have enhanced this technique's predictive and therapeutic potential. Nuclear imaging potentially helps doctors pinpoint the causative factors of left ventricular dysfunction, as with cardiac sarcoidosis and amyloidosis.
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Affiliation(s)
- Navneet Kaur
- Department of Pharmacology, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India
| | - Rahul Kumar Sharma
- Department of Pharmacology, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India
| | - Ajay Singh Kushwah
- Department of Pharmacology, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India
| | - Nisha Singh
- Department of Pharmacology, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India
| | - Shilpa Thakur
- Department of Pharmacology, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India
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Ziegler V, Deußen M, Schumacher L, Roos WP, Fritz G. Anticancer drug and ionizing radiation-induced DNA damage differently influences transcription activity and DDR-related stress responses of an endothelial monolayer. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2020; 1867:118678. [PMID: 32061892 DOI: 10.1016/j.bbamcr.2020.118678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 01/05/2023]
Abstract
The endothelium contributes to the pathophysiology of adverse effects caused by conventional (genotoxic) anticancer therapeutics (cAT). The relevance of structurally different types of cAT-induced DNA lesions for eliciting selected endothelial stress responses is largely unknown. Here, we analyzed the cAT-induced formation of DNA double-strand breaks (DSB), transcription blockage and DNA damage response (DDR) in time kinetic analyses employing a monolayer of primary human endothelial cells (HUVEC). We observed that the degree of cAT-induced transcription blockage, the number of DSB and activation of DDR-related factors diverge. For instance, ionizing radiation caused the formation of numerous DSB and triggerd a substantial activation of ATM/Chk2 signaling, which however were not accompanied by a significant transcription inhibition. By contrast, the DNA cross-linking cAT cisplatin triggered a rapid and substantial blockage of transcription, which yet was not reflected by an appreciable number of DSB or increased levels of pATM/pChk2. In general, cAT-stimulated ATM-dependent phosphorylation of Kap1 (Ser824) and p53 (Ser15) reflected best cAT-induced transcription blockage. In conclusion, cAT-induced formation of DSB and profound activation of prototypical DDR factors is independent of the inhibition of RNA polymerase II-regulated transcription in an endothelial monolayer. We suggest that DSB formed directly or indirectly following cAT-treatment do not act as comprehensive triggers of superior signaling pathways shutting-down transcription while, at the same time, causing an appreciable stimulation of the DDR. Rather, it appears that distinct cAT-induced DNA lesions elicit diverging signaling pathways, which separately control transcription vs. DDR activity in the endothelium.
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Affiliation(s)
- Verena Ziegler
- Institute of Toxicology, Medical Faculty, Heinrich Heine University, Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany.
| | - Marco Deußen
- Institute of Toxicology, Medical Faculty, Heinrich Heine University, Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany.
| | - Lena Schumacher
- Institute of Toxicology, Medical Faculty, Heinrich Heine University, Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany.
| | - Wynand P Roos
- Institute of Toxicology, University Medical Center Mainz, Obere Zahlbacher Strasse 67, 55131 Mainz, Germany.
| | - Gerhard Fritz
- Institute of Toxicology, Medical Faculty, Heinrich Heine University, Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany.
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Jones LM, Stoner L, Baldi JC, McLaren B. Circuit resistance training and cardiovascular health in breast cancer survivors. Eur J Cancer Care (Engl) 2020; 29:e13231. [PMID: 32020706 DOI: 10.1111/ecc.13231] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Cardiovascular disease is the leading cause of death in breast cancer survivors. While evidence shows circuit resistance training (CRT) is effective for improving muscle and cardiorespiratory fitness, whether CRT is an efficacious therapy for decreasing cardiovascular risk in cancer survivors is unclear. METHODS Fifty-one breast cancer survivors were recruited to either 12 weeks CRT (n = 26), or a non-exercising wait-list control (n = 25). Two supervised 60 min CRT sessions per week were undertaken, comprising resistance and functional exercises, and aerobic exercise stations. Primary outcome measure was the gold-standard assessment of arterial stiffness, aortic pulse wave velocity (PWV). Secondary outcomes included: cardiorespiratory fitness (CRF), upper and lower body strength, arterial wave reflections, central blood pressure and rate pressure product. RESULTS Compared to the control group, the CRT group had a statistically significant medium effect decrease in PWV 0.9 m/s (95% CI: 0.1, 1.7). There were large effect improvements in VO2 max (4.3 ml kg-1 min-1 , 95% CI: 5.8, 2.8), upper and lower body strength (3.7 kg, 95% CI: 1.9, 5.6 and 10.4 kg, 1.6, 19.1) respectively. CONCLUSION Findings support the existing literature demonstrating that 12 weeks CRT improves muscle and cardiorespiratory fitness and is also an effective strategy for decreasing a proven cardiovascular risk factor in breast cancer survivors.
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Affiliation(s)
- Lynnette M Jones
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Lee Stoner
- Department of Exercise & Sport Science, Chapel Hill, NC, USA
| | - J Chris Baldi
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Blair McLaren
- Southern Blood and Cancer Service, Dunedin, New Zealand
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Subclinical Cardiovascular Disease in Lymphoma Survivors by Sex. J Obstet Gynecol Neonatal Nurs 2016; 45:438-53. [DOI: 10.1016/j.jogn.2015.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 12/29/2022] Open
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Sisakian H. Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies. World J Cardiol 2014; 6:478-494. [PMID: 24976920 PMCID: PMC4072838 DOI: 10.4330/wjc.v6.i6.478] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/06/2014] [Accepted: 03/14/2014] [Indexed: 02/06/2023] Open
Abstract
Cardiomyopathies are defined as diseases of the myocardium with associated structural and functional abnormalities. Knowledge of these pathologies for a long period was not clear in clinical practice due to uncertainties regarding definition, classification and clinical diagnosis. In recent decades, major advances have been made in the understanding of the molecular and genetic issues, pathophysiology, and clinical and radiological assessment of the diseases. Progress has been made also in management of several types of cardiomyopathy. Advances in the understanding of these diseases show that cardiomyopathies represent complex entities. Here, special attention is given to evolution of classification of cardiomyopathies, with the aim of assisting clinicians to look beyond schematic diagnostic labels in order to achieve more specific diagnosis. Knowledge of the genotype of cardiomyopathies has changed the pathophysiological understanding of their etiology and clinical course, and has become more important in clinical practice for diagnosis and prevention of cardiomyopathies. New approaches for clinical and prognostic assessment are provided based on contemporary molecular mechanisms of contribution in the pathogenesis of cardiomyopathies. The genotype-phenotype complex approach for assessment improves the clinical evaluation and management strategies of these pathologies. The review covers also the important role of imaging methods, particularly echocardiography, and cardiac magnetic resonance imaging in the evaluation of different types of cardiomyopathies. In summary, this review provides complex presentation of current state of cardiomyopathies from genetics to management aspects for cardiovascular specialists.
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Measurement of Arterial Activity on Routine FDG PET/CT Images Improves Prediction of Risk of Future CV Events. JACC Cardiovasc Imaging 2013; 6:1250-9. [DOI: 10.1016/j.jcmg.2013.08.006] [Citation(s) in RCA: 232] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/03/2013] [Accepted: 08/09/2013] [Indexed: 11/23/2022]
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Carver JR, Szalda D, Ky B. Asymptomatic cardiac toxicity in long-term cancer survivors: defining the population and recommendations for surveillance. Semin Oncol 2013; 40:229-38. [PMID: 23540748 PMCID: PMC3686285 DOI: 10.1053/j.seminoncol.2013.01.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Advances in the treatment of pediatric and adult cancer have reduced the mortality rates from these disorders and have led to an ever-increasing population of long-term survivors. Chemotherapy and radiotherapy may cause premature cardiac disease that may be asymptomatic or symptomatic. All patients exposed to chemotherapy with cardiotoxic potential or chest radiotherapy have stage A heart failure and the goal of surveillance and treatment is to prevent progression to stages B-D. Screening strategies, including the use of biomarkers, echocardiography, and expert opinion surveillance and treatment recommendations, are presented.
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Affiliation(s)
- Joseph R Carver
- Cardio-oncology in the Division of Cardiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Schmitz KH, Prosnitz RG, Schwartz AL, Carver JR. Prospective surveillance and management of cardiac toxicity and health in breast cancer survivors. Cancer 2012; 118:2270-6. [DOI: 10.1002/cncr.27462] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Enright KA, Krzyzanowska MK. Control of cardiovascular risk factors among adult cancer survivors: a population-based survey. Cancer Causes Control 2010; 21:1867-74. [PMID: 20645125 DOI: 10.1007/s10552-010-9614-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 07/02/2010] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Cardiovascular disease (CVD) is a major cause of morbidity and mortality in cancer survivors, with the risk increasing significantly with the presence of multiple cardiac risk factors (RF). The proportion of cancer survivors at elevated risk of CVD on the basis of multiple RF is unknown. METHODS The National Health and Nutrition Examination Survey (NHANES 1999-2006) was used to examine the proportion of cancer survivors with multiple RF (≥2RF) and those at high cardiac risk (≥4 RF) compared with matched controls. RF (hypertension, hypercholesterolemia, weight, exercise, smoking) were defined according to AHA/ACC. RESULTS A total of 1,227 cancer survivors and 4,782 controls were identified. The majority of both cancer survivors and controls had multiple RF (91.5 vs. 89.9%) with a substantial proportion at high cardiac risk (35.2 vs. 32.6%). Compared to controls, survivors were more likely to be smokers (34.5 vs. 25.7%, p = 0.001), but less likely be overweight (67.2 vs. 72.0%, p = 0.02). There was no significant difference in the proportion with hypertension (30.6 vs. 30.8%), hypercholesterolemia (52.4 vs. 54.7%) or low exercise (75.6 vs. 73.0%). Among survivors, only age was associated with RF; with older survivors significantly more likely to have poor control than younger survivors (p = 0.005). CONCLUSION The prevalence of multiple RF was similar but suboptimal among cancer survivors and controls. Cardiac RF control, particularly among older survivors, is an important area of focus for improvement in survivorship care.
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Affiliation(s)
- K A Enright
- Department of Medical Oncology & Hematology, Princess Margaret Hospital, Suite 5-206, 610 University Ave, Toronto, ON M5G 2M9, Canada.
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Carver JR, Schuster SJ, Glick JH. Doxorubicin cardiotoxicity in the elderly: old drugs and new opportunities. J Clin Oncol 2008; 26:3122-4. [PMID: 18591552 DOI: 10.1200/jco.2008.16.5274] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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