Abstract
Cardiovascular diseases have multifactorial causes. Classical cardiovascular risk factors, such as arterial hypertension, smoking, hyperlipidemia, and diabetes associate with the development of vascular stenoses and coronary heart disease. Further comorbidities and its impact on cardiovascular metabolism have gotten more attention recently. Thus, also cancer biology may affect the heart, apart from cardiotoxic side effects of chemotherapies. Cancer is a systemic disease which primarily leads to metabolic alterations within the tumor. An emerging number of preclinical and clinical studies focuses on the interaction between cancer and a maladaptive crosstalk to the heart. Cachexia and sarcopenia can have dramatic consequences for many organ functions, including cardiac wasting and heart failure. These complications significantly increase mortality and morbidity of heart failure and cancer patients. There are concurrent metabolic changes in fatty acid oxidation (FAO) and glucose utilization in heart failure as well as in cancer, involving central molecular regulators, such as PGC-1α. Further, specific inflammatory cytokines (IL-1β, IL-6, TNF-α, INF-β), non-inflammatory cytokines (myostatin, SerpinA3, Ataxin-10) and circulating metabolites (D2-HG) may mediate a direct and maladaptive crosstalk of both diseases. Additionally, cancer therapies, such as anthracyclines and angiogenesis inhibitors target common metabolic mechanisms in cardiomyocytes and malignant cells. This review focuses on cardiovascular, cancerous, and cancer therapy-associated alterations on the systemic and cardiac metabolic state.
Highlights
A percentage of 18% of cancer patients are seen with cardiovascular comorbidities in large population-based studies
Cardiovascular complications range from stroke to arrhythmias, coronary heart disease (CHD), cardiomyopathy, heart failure (HF), or valvular diseases (Liu et al, 2019)
Splanchnic congestion may lead to impaired intestinal barrier function and thereby to a systemic inflammatory response and cytokine release, which in turn may result in lean mass loss and cardiac muscle wasting (Aoyagi et al, 2015)
Summary
A percentage of 18% of cancer patients are seen with cardiovascular comorbidities in large population-based studies. Cancer Impacts Cardiac Metabolism in patients suffering from prostate cancer, breast cancer, lung cancer or urinary bladder cancer (Sturgeon et al, 2019). Cardiovascular diseases itself, such as CHD and HF, are mostly attributed to the occurrence of cardiovascular risk factors (e.g., arterial hypertension, diabetes, smoking, age, hypercholesterinemia, and adiposity) or predisposing genetic factors (Jacoby and McKenna, 2012; McPherson and TybjaergHansen, 2016; Piepoli et al, 2016). Anaerobic glycolysis and lactate production is one of the central mechanisms in tumor metabolism This includes a dysregulation of key enzymes in different glycolysis pathways. This review focuses on the available data of concurrent and causative metabolic events in cardiac disease and cancer and its impact on cardiac dysfunction and cancer progression, respectively
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