Circulating biomarkers for management of cancer therapeutics related cardiac dysfunction

Cancer therapeutics related cardiac dysfunction (CTRCD) has emerged as a major cause of morbidity and mortality in cancer survivors. Effective clinical management of CTRCD is impeded by a lack of sensitive diagnostic and prognostic strategies. Circulating molecular markers could potentially address this need as they are often indicative of cardiac stress before cardiac damage can be detected clinically. A growing understanding of the underlying physiological mechanisms for CTRCD has inspired research efforts to identify novel pathophysiologically-relevant biomarkers that may also guide development of cardio-protective therapeutic approaches. The purpose of this review is to evaluate current circulating biomarkers of cardiac stress and their potential role in diagnosis and management of CTRCD. We also discuss some emerging avenues for CTRCD-focused biomarker investigations.

Cardiovascular involvement in patients affected by multiple myeloma: a comprehensive review of recent advances

INTRODUCTION

Multiple Myeloma (MM) is hematological neoplasia originating from plasma cells, which accounts for almost 1% of all oncologic malignancies. The median age of patients at diagnosis is about 65 years old and over. In this age group, cardiovascular (CV) diseases often co-exist, increasing the risk of adverse events related to MM treatment. A comprehensive search on the main educational platforms was performed and high-quality original articles and reviews were included.

AREAS COVERED

Patients affected by MM are at risk for heart failure, uncontrolled systemic hypertension, accelerated ischemic heart disease, arterial/venous thromboembolism, and arrhythmias. These complications may be due to the effects of chemotherapy on the CV system, which may play on preexisting risk factors, and amyloid deposition at cardiac level.

EXPERT OPINION

This review provides an updated overview of the spectrum of CV diseases that may affect MM patients, highlighting possible treatment strategies according to the latest recommendations. Cooperation between onco-hematologist and cardiologist is crucial in managing this population, in particular for adequate risk assessment, early diagnosis of CV complications, and proper treatment.

Hyperhomocysteinemia as a Link of Chemotherapy-Related Endothelium Impairment

Atherosclerosis is a well-known risk factor of cardiovascular disease development. This research presents the AC mode of chemotherapy-related homocysteine level changes, with the simultaneous trimetazidine administration as a possible therapeutic inhibitor of chemotherapy-associated disturbances of morphofunctional homeostasis, for assessing the possible normalization effects. In order to the implementation of this experimental research, 80 Wistar rats were used. The chemotherapy was administered in AC mode. Trimetazidine was used as a stabilizer of homocysteine concentration. Analysis of homocysteine concentration was carried out by quantitative enzyme immunoassay. Given results state that AC-mode of chemotherapy modulates homocysteine production, a known risk factor for endothelial dysfunction development. At the same time, trimetazidine showed an unexpected limitation of homocysteine concentration. The obtained data indicate that hyperhomocysteinemia also plays a particular role in implementing the chemotherapy-induced cardiovascular disturbances continuum. While homocysteine's stabilizing properties of trimetazidine appear to be quite promising, withal further research is needed.