Sex differences in anthracycline-induced cardiotoxicity: the benefits of estrogens
File(s)
Supporting information
Supporting information
Author(s)
Type
Journal Article
Abstract
Anthracyclines are the cornerstone for many oncologic treatments, but their cardiotoxicity has been recognized for several decades. Female subjects, especially before puberty and adolescence, or after menopause, seem to be more at increased risk, with the prognostic impact of this sex issue being less consistent compared to other cardiovascular risk factors. Several studies imply that sex differences could depend on the lack of the protective effect of sex hormones against the anthracycline-initiated damage in cardiac cells, or on differential mitochondria-related oxidative gene expression. This is also reflected by the results obtained with different diagnostic methods, such as cardiovascular biomarkers and imaging techniques (echocardiography, magnetic resonance, and nuclear medicine) in the diagnosis and monitoring of cardiotoxicity, confirming that sex differences exist. The same is true about protective strategies from anthracycline cardiotoxicity. Indeed, first studied to withstand oxidative damage in response to ischemia/reperfusion (I/R) injury, cardioprotection has different outcomes in men and women. A number of studies assessed the differences in I/R response between male and female hearts, with oxidative stress and apoptosis being shared mechanisms between the I/R and anthracyclines heart damage. Sex hormones can modulate these mechanisms, thus confirming their importance in the pathophysiology in cardioprotection not only from the ischemia/reperfusion damage, but also from anthracyclines, fueling further cardio-oncologic research on the topic.
Date Issued
2019-11-01
Date Acceptance
2019-06-01
Citation
Heart Failure Reviews, 2019, 24 (6), pp.915-925
ISSN
1382-4147
Publisher
Springer (part of Springer Nature)
Start Page
915
End Page
925
Journal / Book Title
Heart Failure Reviews
Volume
24
Issue
6
Copyright Statement
© Springer Science+Business Media, LLC, part of Springer Nature 2019. The final publication is available at Springer via https://doi.org/10.1007/s10741-019-09820-2
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000494934200005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Anthracycline cardiotoxicity
Gender differences
Pathophysiology
monitoring
and protection from anthracycline cardiotoxicity
CHILDHOOD-CANCER SURVIVORS
BREAST-CANCER
WORKING GROUP
POSITION PAPER
HEART-FAILURE
CARDIAC DYSFUNCTION
DRUG CARDIOTOXICITY
AMERICAN SOCIETY
SPECKLE-TRACKING
RISK-FACTORS
Publication Status
Published
Date Publish Online
2019-06-29