The Role of Vasospasm and Microcirculatory Dysfunction in Fluoropyrimidine-Induced Ischemic Heart Disease

Fabin, Natalia; Bergami, Maria; Cenko, Edina; Bugiardini, Raffaele; Manfrini, Olivia

doi:10.3390/jcm11051244

Cited by 8 publications

(5 citation statements)

References 90 publications

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“…Cardiomyocyte apoptosis, inflammation, endothelial dysfunction, calcium dysregulation, and mitochondrial damage, promoting hypertension, cardiomyopathy, myocardial infarction, arrhythmias, and heart failure (HF) have been observed in patients treated with Cyclophosphamide [ 51 ]. 5-Fluorouracil (5-FU) has been associated with the acute coronary syndrome, probably due to a decrease in nitric oxide locally, causing coronary artery spasm and vasoconstriction, microvascular thrombus, and finally myocardial ischemia [ 52 ].…”

Section: Chemotherapy-induced Cardiotoxicity In Childrenmentioning

confidence: 99%

Circulating Biomarkers for Monitoring Chemotherapy-Induced Cardiotoxicity in Children

Meo,

Savarese,

Munno

et al. 2023

Pharmaceutics

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Most commonly diagnosed cancer pathologies in the pediatric population comprise leukemias and cancers of the nervous system. The percentage of cancer survivors increased from approximatively 50% to 80% thanks to improvements in medical treatments and the introduction of new chemotherapies. However, as a consequence, heart disease has become the main cause of death in the children due to the cardiotoxicity induced by chemotherapy treatments. The use of different cardiovascular biomarkers, complementing data obtained from electrocardiogram, echocardiography cardiac imaging, and evaluation of clinical symptoms, is considered a routine in clinical diagnosis, prognosis, risk stratification, and differential diagnosis. Cardiac troponin and natriuretic peptides are the best-validated biomarkers broadly accepted in clinical practice for the diagnosis of acute coronary syndrome and heart failure, although many other biomarkers are used and several potential markers are currently under study and possibly will play a more prominent role in the future. Several studies have shown how the measurement of cardiac troponin (cTn) can be used for the early detection of heart damage in oncological patients treated with potentially cardiotoxic chemotherapeutic drugs. The advent of high sensitive methods (hs-cTnI or hs-cTnT) further improved the effectiveness of risk stratification and monitoring during treatment cycles.

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Section: Chemotherapy-induced Cardiotoxicity In Childrenmentioning

confidence: 99%

Circulating Biomarkers for Monitoring Chemotherapy-Induced Cardiotoxicity in Children

Meo,

Savarese,

Munno

et al. 2023

Pharmaceutics

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“… 100 Interestingly, in cancer patients, SPECT-detected myocardial ischaemia does not correlate well with underlying obstructive CAD, 97 highlighting the importance of coronary microvascular dysfunction (CMVD) and coronary spasm in this population. 101 – 103 …”

Section: Diagnosis Of Cancer-treatment-related Toxicitymentioning

confidence: 99%

Tales from the future—nuclear cardio-oncology, from prediction to diagnosis and monitoring

Mikaïl

Chequer

Impériale

et al. 2023

European Heart Journal - Cardiovascular Imaging

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Cancer and cardiovascular disease often share common risk factors, and patients with cardiovascular disease who develop cancer are at high risk of experiencing major adverse cardiac events. Additionally, cancer treatment can induce short- and long-term adverse cardiovascular events. Given the improvement in oncological patients’ prognosis, the burden in this vulnerable population is slowly shifting towards increased cardiovascular mortality. Consequently, the field of cardio-oncology is steadily expanding, prompting the need for new markers to stratify and monitor the cardiovascular risk in oncological patients before, during, and after the completion of treatment. Advanced noninvasive cardiac imaging has raised great interest in the early detection of cardiovascular diseases and cardiotoxicity in oncological patients. Nuclear medicine has long been a pivotal exam to robustly assess and monitor the cardiac function of patients undergoing potentially cardiotoxic chemotherapies. In addition, recent radiotracers have shown great interest in the early detection of cancer treatment-related cardiotoxicity. In this review, we summarize the current and emerging nuclear cardiology tools that can help identify cardiotoxicity and assess the cardiovascular risk in patients undergoing cancer treatments, and discuss the specific role of nuclear cardiology alongside other noninvasive imaging techniques.

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“…In addition, coronary artery obstruction, high-intensity labor, and overeating may also cause AMI. A high rate of sudden death is associated with untimely effective treatment measures (5)(6)(7). A sharp reduction or complete interruption of coronary artery blood supply in patients with AMI leads to severe and long-lasting acute ischemia, which can cause myocardial cell necrosis and abnormal heart function.…”

Section: Introductionmentioning

confidence: 99%

Effect of different pre-hospital first aid methods on the efficacy and prognosis of acute myocardial infarction with left heart failure: a systematic review and meta-analysis

Lin¹,

Chen²,

Wu³

et al. 2023

J Thorac Dis

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Background: Pre-hospital first aid for acute myocardial infarction (AMI) is an important way to save patients. However, there are still some disputes about the way of pre-hospital first aid. Therefore, this paper provides a Meta-analysis to evaluate the efficacy and prognosis of different prehospital care for AMI with left heart failure.Methods: By searching the published studies in the databases, the literature related to the pre-hospital first aid for patients with AMI and left heart failure was screened out. The quality of the literature was evaluated according to the Newcastle-Ottawa scale (NOS), and the corresponding data were extracted for metaanalysis. Meta-analysis was performed on 7 outcome indicators (clinical effect of patients after treatment, respiratory rate, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), survival status, and incidence of complications). A funnel plot and Egger's test were used to test risk of bias.Results: A total of 16 articles were finally included, comprising a total of 1,465 patients. The literature quality evaluation found that 8 literatures were rated as low risk of bias, and 8 literatures were rated as medium risk of bias. The meta-analysis results showed that the clinical effect of the first aid and then transportation group was better than that of the transportation and then first aid group [risk ratio (RR) =1.35, 95% confidence interval (CI): 1.27 to 1.45, P<0.01]; the respiratory rate decreased [mean difference (MD) =−4.84, 95% CI: −6.50 to −3.18, P<0.01]; the heart rate decreased (MD =−11.34, 95% CI: −12.69 to −9.99, P<0.01); SBP decreased (MD =−6.00, 95% CI: −10.00 to −2.00, P<0.01); the DBP decreased (MD =−3.54, 95% CI: −4.45 to −2.64, P<0.01); the survival status of the patients improved (RR =1.29, 95% CI: 1.18 to 1.41, P<0.01); the incidence of complications was reduced (RR =0.31, 95% CI: 0.20 to 0.48, P<0.01).Conclusions: Pre-hospital first aid and then transportation can significantly improve the clinical treatment effect of patients. However, considering that the literatures included in this paper are non-randomized controlled studies and the overall quality of the included literatures is not high and the number of studies is limited, further exploration is needed.

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The Role of Vasospasm and Microcirculatory Dysfunction in Fluoropyrimidine-Induced Ischemic Heart Disease

Cited by 8 publications

References 90 publications

Circulating Biomarkers for Monitoring Chemotherapy-Induced Cardiotoxicity in Children

Circulating Biomarkers for Monitoring Chemotherapy-Induced Cardiotoxicity in Children

Tales from the future—nuclear cardio-oncology, from prediction to diagnosis and monitoring

Effect of different pre-hospital first aid methods on the efficacy and prognosis of acute myocardial infarction with left heart failure: a systematic review and meta-analysis

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