Jacc: Cardiooncology最新文献

{"title":"Cancer and Cardiovascular Disease","authors":"Laith Alhuneafat MD ,&nbsp;Avirup Guha MD, MPH ,&nbsp;Anne Blaes MD, MS ,&nbsp;Suma H. Konety MD, MS","doi":"10.1016/j.jaccao.2025.07.001","DOIUrl":"10.1016/j.jaccao.2025.07.001","url":null,"abstract":"<div><div>Cancer and cardiovascular disease (CVD) remain the leading causes of morbidity and mortality worldwide, with emerging evidence highlighting their complex and bidirectional interplay. Shared risk factors, including aging, systemic inflammation, metabolic dysregulation, and lifestyle behaviors, can contribute to their co-occurrence while underlying biological mechanisms such as oxidative stress, chronic inflammation, and clonal hematopoiesis further reinforce their connection. These mechanisms drive pathophysiological changes contributing to disease progression, increasing susceptibility to both conditions. This review explores the epidemiology, overlapping biological pathways, and risk factors linking cancer and CVD, emphasizing key mechanisms such as epigenetic modifications, immune system dysregulation, and cellular senescence. Future research should aim to identify biomarkers, refine risk models, and develop targeted strategies to mitigate disease burden and improve outcomes.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 5","pages":"Pages 453-469"},"PeriodicalIF":12.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Age Acceleration Mediates Treatment Effects on Cardiometabolic and Cardiovascular Risk in Childhood Cancer Survivors.","authors":"Xiaoxi Meng, Tiffany Eulalio, Yoonji Kim, John Easton, Heather L Mulder, Emily Walker, Geoffrey Neale, Nan Song, Kyla Shelton, Rebecca M Howell, Mengqi Xing, Sedigheh Mirzaei, Deo Kumar Srivastava, Bonnie Ky, Stephanie B Dixon, Melissa M Hudson, Kirsten K Ness, Gregory T Armstrong, Zhaoming Wang","doi":"10.1016/j.jaccao.2025.06.001","DOIUrl":"10.1016/j.jaccao.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>Childhood cancer survivors are at increased risk for epigenetic age acceleration (EAA) and subsequent morbidities, including cardiometabolic risk factors (CMRFs) and cardiovascular diseases, because of prior genotoxic treatments.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the mediating role of EAA in the relationship between cancer treatment exposures and risk for CMRFs and cardiovascular diseases.</p><p><strong>Methods: </strong>This study included 2,939 5-year survivors from SJLIFE (St. Jude Lifetime Cohort) who underwent DNA methylation profiling using peripheral blood mononuclear cells. EAA was calculated using 3 established epigenetic clocks: DunedinPACE, PCPhenoAge, and GrimAge2. Treatment data, including body region-specific radiotherapy (RT) and chemotherapeutic agents such as anthracyclines and corticosteroids, were abstracted from medical records. Outcomes included 3 CMRFs (abnormal glucose metabolism, hypertension, and obesity) and 2 cardiovascular diseases (cardiomyopathy and myocardial infarction). Mediation analysis was conducted to quantify the extent to which EAA mediated the association between each treatment exposure and each clinical outcome.</p><p><strong>Results: </strong>EAA partially mediated the associations between abdominal RT and abnormal glucose metabolism (DunedinPACE 35.4%, GrimAge2 16.2%), between abdominal RT (DunedinPACE 25.9%) or anthracyclines (DunedinPACE 12.5%) and hypertension, and between corticosteroids and obesity (DunedinPACE 8.6%). EAA also mediated the associations between heart RT and cardiomyopathy (PCPhenoAge 30.3%, DunedinPACE 19.9%, GrimAge2 14.4%) and myocardial infarction (PCPhenoAge 24.1%, DunedinPACE 15.5%, GrimAge2 13.2%), and anthracyclines and cardiomyopathy (GrimAge2 6.0%, PCPhenoAge 5.2%, DunedinPACE 3.9%).</p><p><strong>Conclusions: </strong>EAA accounted for a substantial proportion of the association between cancer treatment exposures and risk for CMRFs and cardiovascular diseases. These findings provide insight into biological aging as a potential mechanistic pathway and support the development of interventions targeting accelerated aging to mitigate long-term treatment-related toxicities and reduce premature mortality in this high-risk population.</p>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IGHG Recommendations for Anthracycline and Anthraquinone Cardiac Dysfunction Equivalence Ratios After Childhood Cancer: JACC: CardioOncology Expert Panel.","authors":"Theodorus W Kouwenberg, Elvira C van Dalen, Renée L Mulder, Saro Armenian, Elizabeth A M Feijen, Eric J Chow, Helen Kosmidis, Britta J Vormoor-Bürger, Chikako Kiyotani, Paul C Nathan, Livia Kapusta, Heynric B Grotenhuis, Frederike K Engels, Arco J Teske, Athanasios Tragiannidis, Martijn G Slieker, Shuichi Ozono, Anju Nohria, Tomáš Sláma, Roderick Skinner, Melissa M Hudson, Leontien C M Kremer, Matthew J Ehrhardt, Annelies M C Mavinkurve-Groothuis","doi":"10.1016/j.jaccao.2025.05.009","DOIUrl":"10.1016/j.jaccao.2025.05.009","url":null,"abstract":"<p><p>Anthracycline and anthraquinone agents are major contributors to cancer therapy-related cardiac dysfunction in childhood cancer. However, evidence-based equivalence ratios for estimating individual risk have not been incorporated into international surveillance guidelines. The International Late Effects of Childhood Cancer Guideline Harmonization Group systematically reviewed the literature on equivalence ratios for doxorubicin, daunorubicin, epirubicin, idarubicin, and mitoxantrone. Based on available evidence, benefit-harm considerations, and expert consensus, the panel concluded that the risk of cardiac dysfunction is lower with daunorubicin and higher with mitoxantrone compared with doxorubicin (moderate-quality evidence; strong recommendation). The panel recommends using an approximate ratio of 0.6 to convert daunorubicin to a doxorubicin-equivalent dose and a ratio of 10.5 for mitoxantrone (low-quality evidence; moderate recommendation). No recommendation was made for epirubicin or idarubicin due to inconclusive evidence.</p>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mismatch Between Preclinical Cardio-Oncology and Clinical Oncology Research.","authors":"Rachele Cagnazzo, Mario Stabile, Gabriele Zoppoli, Rudolf A De Boer, Wouter C Meijers, Peter van Der Meer, Pietro Ameri","doi":"10.1016/j.jaccao.2025.05.012","DOIUrl":"10.1016/j.jaccao.2025.05.012","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoropyrimidine Therapy in Gastrointestinal Cancer","authors":"Mohamad Bassam Sonbol MD ,&nbsp;Tanios Bekaii-Saab MD ,&nbsp;Carolyn M. Larsen MD","doi":"10.1016/j.jaccao.2025.02.006","DOIUrl":"10.1016/j.jaccao.2025.02.006","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 357-359"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2666-0873(25)00240-6","DOIUrl":"10.1016/S2666-0873(25)00240-6","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages I-CXXXII"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Care After Cancer","authors":"Nina Nouhravesh MD, PhD,&nbsp;Morten Schou MD, PhD","doi":"10.1016/j.jaccao.2025.05.005","DOIUrl":"10.1016/j.jaccao.2025.05.005","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 379-381"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigation of Doxorubicin Cardiotoxicity With Synergistic miRNA Combinations Identified Using Combinatorial Genetics en masse (CombiGEM)","authors":"Yasutomi Higashikuni MD, PhD ,&nbsp;Colin Platt PhD ,&nbsp;Margaret H. Hastings PhD ,&nbsp;William C.W. Chen MD, PhD ,&nbsp;Justin R.B. Guerra BS ,&nbsp;Takeshi Tokuyama PhD ,&nbsp;Fuad Gandhi Torizal DDS, PhD ,&nbsp;Wenhao Liu MD ,&nbsp;Takumi Obana ,&nbsp;Abraham L. Bayer BS ,&nbsp;Hannah Whipple BS ,&nbsp;Alexandra Kuznetsov BA ,&nbsp;Ashish Yeri PhD ,&nbsp;Cole Turissini BS ,&nbsp;Robert R. Kitchen PhD ,&nbsp;Kota Shibayama ,&nbsp;Takayoshi Matsumura MD, PhD ,&nbsp;Norihiko Takeda MD, PhD ,&nbsp;Hideki Uosaki MD, PhD ,&nbsp;Aarti H. Asnani MD ,&nbsp;Anthony Rosenzweig MD","doi":"10.1016/j.jaccao.2025.03.007","DOIUrl":"10.1016/j.jaccao.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Cardiomyocyte loss occurs in acute and chronic cardiac injury, including cardiotoxicity due to chemotherapeutics like doxorubicin, and contributes to heart failure development. There is a pressing need for cardiac-specific therapeutics that target cardiomyocyte loss, preventing chemotherapy complications without compromising chemotherapeutic efficacy.</div></div><div><h3>Objectives</h3><div>The authors employed massively parallel combinatorial genetic screening to find microRNA (miRNA) combinations that promote cardiomyocyte survival.</div></div><div><h3>Methods</h3><div>CombiGEM (combinatorial genetics en masse) screening in a cardiomyocyte cell line was followed by validation in the original cell type and screening in primary cardiomyocytes. The top combination was tested in mouse and developing zebrafish models of doxorubicin cardiotoxicity. RNA sequencing provided insight into possible mechanisms.</div></div><div><h3>Results</h3><div>Multiple miRNA combinations protected cardiomyocytes from doxorubicin in vitro. The most effective (miR-222+miR-455) appeared to act synergistically, and mitigated doxorubicin cardiotoxicity phenotypes in murine and zebrafish in vivo models. RNA sequencing revealed overlapping and synergistic regulation of relevant genes and biological processes in cardiomyocytes, including mitochondrial homeostasis, oxidative stress, muscle contraction, and others.</div></div><div><h3>Conclusions</h3><div>We identified miR-222 and miR-455 as a combination with potential therapeutic applications for cardioprotection. This study furthers our knowledge of the cardiac effects of miRNAs and their combinations and demonstrates the potential of CombiGEM for cardioprotective combinatorial therapeutic discovery.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 396-410"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Cardiovascular Disease in Cancer Survivors after Systemic Treatment","authors":"Frits I. Mulder MD ,&nbsp;Erzsébet Horváth-Puhó PhD ,&nbsp;Nick van Es MD ,&nbsp;Lars Pedersen PhD ,&nbsp;Harry R. Büller PhD ,&nbsp;Deirdre Cronin-Fenton PhD ,&nbsp;Christian F. Christiansen MD, PhD ,&nbsp;Hans Erik Bøtker MD, PhD ,&nbsp;Krishnan Bhaskaran PhD ,&nbsp;Henrik T. Sørensen MD, PhD","doi":"10.1016/j.jaccao.2025.03.008","DOIUrl":"10.1016/j.jaccao.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Patients face an increased risk of cardiovascular disease shortly after a cancer diagnosis, but evidence on long-term risk among cancer survivors remains limited.</div></div><div><h3>Objectives</h3><div>In this study the authors sought to estimate the risk of cardiovascular disease in cancer survivors previously treated with systemic cancer therapy.</div></div><div><h3>Methods</h3><div>Using Danish population-based registries, we identified individuals who had received systemic cancer treatment and were free of both cancer and treatment 3 years after diagnosis (index date). For each cancer survivor, 5 cancer-free individuals from the general population were randomly selected, matched by birth year, sex, and calendar year. Participants were followed from the index date for up to 5 years. HRs were estimated using Cox regression, adjusted for potential confounders.</div></div><div><h3>Results</h3><div>Compared with 457,035 matched individuals, the 91,407 cancer survivors had an increased risk of heart failure or cardiomyopathy (HR: 1.08; 95% CI: 1.02-1.15), venous thromboembolism (HR: 1.50; 95% CI: 1.41-1.61), pericarditis, endocarditis, or myocarditis (HR: 1.30; 95% CI: 1.11-1.52), and kidney failure (HR: 1.17; 95% CI: 1.10-1.25), but not of ischemic heart disease, stroke, or atrial fibrillation. Estimates varied substantially by cancer type and treatment agent. For example, venous thromboembolism risk was consistently increased across nearly all cancer types, whereas hypertension risk was elevated for none. Ischemic heart disease risk was increased only among lung cancer survivors. Stroke was associated with platinum compounds but not with other systemic treatments.</div></div><div><h3>Conclusions</h3><div>Several cardiovascular disease risks were elevated among cancer survivors, with substantial variation by cancer type and treatment.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 360-378"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Following Hematopoietic Stem Cell Transplantation","authors":"Georgia K. Thomas MD, PhD ,&nbsp;Josh West MS ,&nbsp;Michele Golino MD, PhD ,&nbsp;Emily Kontos BS ,&nbsp;Emily Federmann MS ,&nbsp;William Clark MD ,&nbsp;John McCarty MD ,&nbsp;Thomas Chelimsky MD ,&nbsp;Benjamin VanTassell PharmD ,&nbsp;Maria Toumpourleka MD ,&nbsp;Pietro E. Lazzerini MD ,&nbsp;Stavros Stavrakis MD, PhD ,&nbsp;Antonio Abbate MD, PhD","doi":"10.1016/j.jaccao.2025.05.002","DOIUrl":"10.1016/j.jaccao.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Postural orthostatic tachycardia (POTS) and orthostatic hypotension (OH) commonly occur after hematopoietic stem cell transplantation (HSCT).</div></div><div><h3>Objectives</h3><div>This study sought to determine the prevalence of POTS and OH before HSCT and the incidence of new cases after HSCT.</div></div><div><h3>Methods</h3><div>In this single-center, prospective study, patients were evaluated 30 days before and 30 and 100 days after HSCT. Blood pressure, heart rate, and plasma norepinephrine levels were measured in the supine position and after a 10-minute active stand test to assess for POTS or OH. After HSCT, adrenergic receptor (AR)–modulating autoantibody activity was measured in 8 subjects with POTS and 8 without.</div></div><div><h3>Results</h3><div>Among 46 patients, 40 (87.0%) underwent autologous and 6 (13.0%) allogeneic HSCT. Multiple myeloma was the most common indication (67.4%). Before HSCT, the prevalence of both POTS and OH was 4.3%. At 30 days after HSCT, POTS was present in 10 (25.6%) of 39 patients, including 9 (23.1%) new cases, and OH in 6 (15.4%), including 5 (12.8%) new cases. Patients with POTS at 30 days showed a significantly greater increase in norepinephrine levels upon standing (median 231% [Q1-Q3: 179%-343%]) compared with before HSCT (median 100% [Q1-Q3: 62%-183%]) (<em>P</em> = 0.005), which positively correlated with heart rate changes. AR-modulating autoantibody activity was also higher in patients with POTS vs those without and directly correlated with heart rate changes.</div></div><div><h3>Conclusions</h3><div>Approximately 1 in 4 patients developed POTS after HSCT, characterized by exaggerated increases in norepinephrine upon standing and elevated AR-modulating autoantibody activity.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 382-392"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}