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RESEARCH PRODUCT
Sex differences in anthracycline-induced cardiotoxicity: the benefits of estrogens
Donato MeleInes MonteCarlo G. TocchettiGiuseppina NovoCinzia NugaraChristian Cadeddu DessalviConcetta ZitoGiuseppe MercuroClaudia PennaJavid MoslehiRudolf A. De BoerAlexander R. LyonAlessia PepeRosalinda MadonnaAlessia Gimellisubject
MaleCardiac & Cardiovascular SystemsMagnetic Resonance Spectroscopyand protection from anthracycline cardiotoxicitymedicine.disease_causeBioinformaticsRisk FactorsAnthracycline cardiotoxicityGender differenceGender differencesAnthracyclinesGonadal Steroid Hormones1102 Cardiorespiratory Medicine and HaematologyAMERICAN SOCIETYCardioprotectionSex CharacteristicsHeartPrognosisMitochondriaMenopauseEchocardiographyReperfusion InjuryHEART-FAILUREAnthracycline cardiotoxicity; Gender differences; Pathophysiology monitoring and protection from anthracycline cardiotoxicity; Anthracyclines; Biomarkers; Cardiotonic Agents; Cardiotoxicity; Echocardiography; Female; Gonadal Steroid Hormones; Heart; Heart Failure; Humans; Magnetic Resonance Spectroscopy; Male; Mitochondria; Nuclear Medicine; Oxidative Stress; Prognosis; Reperfusion Injury; Risk Factors; Sex CharacteristicsFemaleCardiology and Cardiovascular MedicineLife Sciences & BiomedicinePOSITION PAPERCARDIAC DYSFUNCTIONCardiotonic AgentsAnthracyclineSPECKLE-TRACKINGIschemiaDRUG CARDIOTOXICITYPathophysiologymedicineHumansCHILDHOOD-CANCER SURVIVORSBREAST-CANCERPathophysiology monitoring and protection from anthracycline cardiotoxicityHeart FailureCardiotoxicityScience & Technologybusiness.industryWORKING GROUPmedicine.diseaseCardiotoxicityOxidative StressmonitoringCardiovascular System & HematologyHeart failureCardiovascular System & CardiologyRISK-FACTORSNuclear MedicinebusinessOxidative stressAnthracycline cardiotoxicity; Gender differences; Pathophysiology monitoring and protection from anthracycline cardiotoxicityBiomarkersHormonedescription
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.
year | journal | country | edition | language |
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2019-11-01 |