Doxorubicin-related cardiotoxicity: review of fundamental pathways of cardiovascular system injury

Ashot Avagimyan¹, Nana Pogosova², Lev Kakturskiy³, Mohammad Sheibani⁴, Abhiram Challa⁵, Eugenia Kogan⁶, Federica Fogacci⁷, Liudmila Mikhaleva³, Rositsa Vandysheva³, Marianna Yakubovskaya⁸, Andrea Faggiano⁹, Stefano Carugo⁹, Olga Urazova¹⁰, Behnaz Jahanbin¹¹, Ekaterina Lesovaya¹², Srujana Polana¹³, Kirill Kirsanov⁸, Yasar Sattar⁵, Artem Trofimenko¹⁴, Tatiana Demura⁶, Amene Saghazadeh¹¹, George Koliakos¹⁵, Davood Shafie¹⁶, Azin Alizadehasl¹⁷, Arrigo Cicero¹⁸, Juan Pablo Costabel¹⁹, Giuseppe Biondi-Zoccai²⁰, Giulia Ottaviani²¹, Nizal Sarrafzadegan²²

Affiliations

¹ Department of Internal Desiases Propedeutics, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia. Electronic address: Avagimyan.cardiology@mail.ru.
² Deputy Director of Research and Preventive Cardiology, National Medical Research Centre of Cardiology named after E. Chazov, Moscow, Russia; Head of Evidence Based Medicine Department, Patrice Lumumba Peoples' Friendship University of Russia (RUDN), Moscow, Russia.
³ A. P. Avtsyn Research Institute of Human Morphology, Petrovskiy RNCS, Moscow, Russia.
⁴ Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Teharan, Iran; Razi Drug Research Centre, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁵ Department of Cardiology, West Virginia University, Morgantown, WV, USA.
⁶ Institute of Clinical Morphology and Digital Pathology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.
⁷ Atherosclerosis and Metabolic Disorders Research Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy.
⁸ Chemical Cancerogenesis Department, Institute of Cancerogenesis, National Medical Research Center of Oncology after N. N. Blokhina, Moscow, Russia; Laboratory of Single Cell Biology, Patrice Lumumba Peoples' Friendship University of Russia (RUDN), Moscow, Russia.
⁹ Department of Cardio-Thoracic-Vascular Area, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
¹⁰ Head of Pathophysiology Department, Siberian State Medical University, Tomsk, Russia.
¹¹ Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
¹² Chemical Cancerogenesis Department, Institute of Cancerogenesis, National Medical Research Center of Oncology after N. N. Blokhina, Moscow, Russia; Laboratory of Single Cell Biology, Patrice Lumumba Peoples' Friendship University of Russia (RUDN), Moscow, Russia; Department of Oncology, Ryazan State Medical University after I. P. Pavlov, Ryazan, Russia.
¹³ Jawaharlal Nehru Medical College, Belgaum, India.
¹⁴ Department of Pathophysiology, Kuban State Medical University, Krasnodar, Russia.
¹⁵ Head of Laboratory of Biological Chemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁶ Director of Heart Failure Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁷ Head of Cardio-Oncology Department and Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
¹⁸ Hypertension and Cardiovascular Risk Research Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy; IRCCS Policlinico S. Orsola-Malpighi di Bologna, Bologna, Italy.
¹⁹ Chief of Coronary Care Unit, Buenos Aires Institute of Cardiology, Buenos Aires, Argentina.
²⁰ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy.
²¹ Anatomic Pathology, Lino Rossi Research Center, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
²² Director of Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

PMID: 39111556
DOI: 10.1016/j.carpath.2024.107683

Review

Doxorubicin-related cardiotoxicity: review of fundamental pathways of cardiovascular system injury

Ashot Avagimyan et al. Cardiovasc Pathol. 2024 Nov-Dec.

. 2024 Nov-Dec:73:107683.

doi: 10.1016/j.carpath.2024.107683. Epub 2024 Aug 5.

Authors

Affiliations

¹ Department of Internal Desiases Propedeutics, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia. Electronic address: Avagimyan.cardiology@mail.ru.
² Deputy Director of Research and Preventive Cardiology, National Medical Research Centre of Cardiology named after E. Chazov, Moscow, Russia; Head of Evidence Based Medicine Department, Patrice Lumumba Peoples' Friendship University of Russia (RUDN), Moscow, Russia.
³ A. P. Avtsyn Research Institute of Human Morphology, Petrovskiy RNCS, Moscow, Russia.
⁴ Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Teharan, Iran; Razi Drug Research Centre, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁵ Department of Cardiology, West Virginia University, Morgantown, WV, USA.
⁶ Institute of Clinical Morphology and Digital Pathology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.
⁷ Atherosclerosis and Metabolic Disorders Research Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy.
⁸ Chemical Cancerogenesis Department, Institute of Cancerogenesis, National Medical Research Center of Oncology after N. N. Blokhina, Moscow, Russia; Laboratory of Single Cell Biology, Patrice Lumumba Peoples' Friendship University of Russia (RUDN), Moscow, Russia.
⁹ Department of Cardio-Thoracic-Vascular Area, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
¹⁰ Head of Pathophysiology Department, Siberian State Medical University, Tomsk, Russia.
¹¹ Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
¹² Chemical Cancerogenesis Department, Institute of Cancerogenesis, National Medical Research Center of Oncology after N. N. Blokhina, Moscow, Russia; Laboratory of Single Cell Biology, Patrice Lumumba Peoples' Friendship University of Russia (RUDN), Moscow, Russia; Department of Oncology, Ryazan State Medical University after I. P. Pavlov, Ryazan, Russia.
¹³ Jawaharlal Nehru Medical College, Belgaum, India.
¹⁴ Department of Pathophysiology, Kuban State Medical University, Krasnodar, Russia.
¹⁵ Head of Laboratory of Biological Chemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁶ Director of Heart Failure Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁷ Head of Cardio-Oncology Department and Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
¹⁸ Hypertension and Cardiovascular Risk Research Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy; IRCCS Policlinico S. Orsola-Malpighi di Bologna, Bologna, Italy.
¹⁹ Chief of Coronary Care Unit, Buenos Aires Institute of Cardiology, Buenos Aires, Argentina.
²⁰ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy.
²¹ Anatomic Pathology, Lino Rossi Research Center, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
²² Director of Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

PMID: 39111556
DOI: 10.1016/j.carpath.2024.107683

Abstract

Over the years, advancements in the field of oncology have made remarkable strides in enhancing the efficacy of medical care for patients with cancer. These modernizations have resulted in prolonged survival and improved the quality of life for these patients. However, this progress has also been accompanied by escalation in mortality rates associated with anthracycline chemotherapy. Anthracyclines, which are known for their potent antitumor properties, are notorious for their substantial cardiotoxic potential. Remarkably, even after 6 decades of research, a conclusive solution to protect the cardiovascular system against doxorubicin-induced damage has not yet been established. A comprehensive understanding of the pathophysiological processes driving cardiotoxicity combined with targeted research is crucial for developing innovative cardioprotective strategies. This review seeks to explain the mechanisms responsible for structural and functional alterations in doxorubicin-induced cardiomyopathy.

Keywords: Cardio-oncology; Cardiotoxicity; Chemotherapy; Doxorubicin.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Doxorubicin-related cardiotoxicity: review of fundamental pathways of cardiovascular system injury

Affiliations

Doxorubicin-related cardiotoxicity: review of fundamental pathways of cardiovascular system injury

Authors

Affiliations

Abstract

Conflict of interest statement

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MeSH terms

Substances

LinkOut - more resources

Full Text Sources