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Review
. 2022 Jul 6:9:936654.
doi: 10.3389/fcvm.2022.936654. eCollection 2022.

Bidirectional Relationship Between Cancer and Heart Failure: Insights on Circulating Biomarkers

Michela Chianca  1 , Giorgia Panichella  1 , Iacopo Fabiani  2 , Alberto Giannoni  1   2 , Serena L'Abbate  1 , Alberto Aimo  1   2 , Annamaria Del Franco  1 , Giuseppe Vergaro  1   2 , Chrysanthos Grigoratos  2 , Vincenzo Castiglione  3 , Carlo Maria Cipolla  4 , Antonella Fedele  4 , Claudio Passino  1   2 , Michele Emdin  1   2 , Daniela Maria Cardinale  4
Affiliations
Review

Bidirectional Relationship Between Cancer and Heart Failure: Insights on Circulating Biomarkers

Michela Chianca et al. Front Cardiovasc Med. .

Abstract

Cancer and heart failure are the two leading causes of death in developed countries. These two apparently distinct clinical entities share similar risk factors, symptoms, and pathophysiological mechanisms (inflammation, metabolic disturbances, neuro-hormonal and immune system activation, and endothelial dysfunction). Beyond the well-known cardiotoxic effects of oncological therapies, cancer and heart failure are thought to be tied by a bidirectional relationship, where one disease favors the other and vice versa. In this context, biomarkers represent a simple, reproducible, sensitive and cost-effective method to explore such relationship. In this review, we recapitulate the evidence on cardiovascular and oncological biomarkers in the field of cardioncology, focusing on their role in treatment-naïve cancer patients. Cardioncological biomarkers are useful tools in risk stratification, early detection of cardiotoxicity, follow-up, and prognostic assessment. Intriguingly, these biomarkers might contribute to better understand the common pathophysiology of cancer and heart failure, thus allowing the implementation of preventive and treatment strategies in cardioncological patients.

Keywords: cancer; cardio-oncology; cardiovascular disease; circulating biomarkers; inflammation; neuro-hormonal activation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Bi-directional relationship between cancer and cardiovascular disease. Analysis of the elevation of disease-specific biomarkers in both conditions suggests a possible influence of cancer on the pathogenesis of cardiovascular disease and vice versa. The elevation of biomarkers is also justified by several pathogenetic pathways shared by both diseases.
See this image and copyright information in PMC

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