Heart failure and cancer: From active exposure to passive adaption

Abstract

The human body seems like a "balance integrator." On the one hand, the body constantly actively receives various outside stimuli and signals to induce changes. On the other hand, several internal regulations would be initiated to adapt to these changes. In most cases, the body could keep the balance in vitro and in vivo to reach a healthy body. However, in some cases, the body can only get to a pathological balance. Actively exposed to unhealthy lifestyles and passively adapting to individual primary diseases lead to a similarly inner environment for both heart failure and cancer. To cope with these stimuli, the body must activate the system regulation mechanism and face the mutual interference. This review summarized the association between heart failure and cancer from active exposure to passive adaption. Moreover, we hope to inspire researchers to contemplate these two diseases from the angle of overall body consideration.

Keywords: Cardio-Oncology; active exposure; cancer; heart failure; passive adaption.

FIGURE 1

Balance in the human body. The human body keeps the balance through people actively exposing to their lifestyles, which leads to various inter-environment. Some of them have to face their basic diseases. The body has to passively adapt to this inter-environment by arousing the system regulation to correct those temporary unbalance or compensate to a certain pathological state. Furthermore, cancer and heart failure have mutual interference.

FIGURE 2

Neuroendocrine regulation of heart failure and cancer. Neuroendocrine system (RAAS, SNS, and NPS) is related to both heart and cancer. They were always aroused to realize functional compensation, but following with cardiac remodeling and then leads to heart failure. In RAAS, increased AT1R and decreased AT2R were associated with cancer progression. In SNS, various kinds of signaling pathways are related to cancer progression (+: increased expression; -: decreased expression). In NPS, NT-proBNP could be a biomarker for monitoring anti-cancer treatment-induced cardiotoxicity.

FIGURE 3

Associations among gut microbiome, cancers, and heart failure. Porphyromonas, Prevotella, Enterococcus, and Streptococcus increased in intestinal and produced DCA which lead to CRC formation and progression. Clostridium is related to HCC. Proteobacteria, Firmicutes, Actinobacteria, Bacteroides, and Fusobacteriaphyla are related to GC. Besides, Helicobacter pylori could induce GC-related gut microbiome which in turn lead to GC. Coriobacteriaceae, Erysipelotrichaceae, Ruminococcaceae, Blautia, and Faecalibacterium are related to heart failure by producing TMAO and decreasing butyrate.