Jacc: Cardiooncology最新文献

{"title":"Fluoropyrimidine Chemotherapy and the Risk of Death and Cardiovascular Events in Patients With Gastrointestinal Cancer","authors":"Aderonke T. Abiodun MBChB ,&nbsp;Chengsheng Ju MPharm, PhD ,&nbsp;Catherine A. Welch BSc, MSc, PhD ,&nbsp;Jennifer Lai MPH, PhD ,&nbsp;Freya Tyrer BSc, MSc, PhD ,&nbsp;Pinkie Chambers MPharm, PhD ,&nbsp;Lizz Paley MSc ,&nbsp;Sally Vernon MMath ,&nbsp;John Deanfield BA ,&nbsp;Mark de Belder MA, MD ,&nbsp;Mark J. Rutherford BSc, MSc, PhD ,&nbsp;Paul C. Lambert MSc, PhD ,&nbsp;Sarah Slater MD ,&nbsp;Kai-Keen Shiu MSc, PhD ,&nbsp;Li Wei MPH, PhD ,&nbsp;Michael D. Peake MD","doi":"10.1016/j.jaccao.2025.01.019","DOIUrl":"10.1016/j.jaccao.2025.01.019","url":null,"abstract":"<div><h3>Background</h3><div>Fluoropyrimidine chemotherapy is administered first-line for many gastrointestinal cancers. However, patients with cardiovascular disease commonly receive alternative treatment due to cardiotoxicity concerns.</div></div><div><h3>Objectives</h3><div>This study sought to assess the risks of all-cause mortality and acute cardiovascular events with fluoropyrimidine treatment.</div></div><div><h3>Methods</h3><div>We conducted an observational cohort study applying a target trial emulation framework to linked national cancer, cardiac, and hospitalization registry data from the Virtual Cardio-Oncology Research Initiative. Adults diagnosed with tumors eligible for fluoropyrimidine-based chemotherapy as first-line therapy were included. All-cause mortality and a composite of hospitalization for acute cardiovascular events (acute coronary syndrome, heart failure, cardiac arrhythmia, cardiac intervention, cardiac arrest, and cardiac death) were compared in patients treated with fluoropyrimidine-based chemotherapy vs alternative management. Adjusted, weighted pooled logistic regression models were used to estimate the 1-year risk difference (RD).</div></div><div><h3>Results</h3><div>Among 103,110 patients (mean age 69.7 years, 59% male), the absolute risk of death at 1 year was significantly lower in fluoropyrimidine-treated patients (RD: −7.7%; 95% CI: −8.7% to −6.7%) with a small increased risk of acute cardiovascular events (RD: 0.9%; 95% CI: 0.0% to 1.9%). This was primarily due to arrhythmias (RD: 0.8%; 95% CI: 0.1% to 1.6%) and cardiac arrest (RD: 0.3%; 95% CI: 0.1% to 0.5%), with no increased risk of acute coronary syndromes including in the subgroup of patients with pre-existing coronary artery disease.</div></div><div><h3>Conclusions</h3><div>The markedly improved overall survival with fluoropyrimidines in patients with gastrointestinal cancer significantly outweighs the small risk of cardiac arrhythmia and arrest. Oncologists should take this into consideration for decision making to avoid undue clinical conservatism, particularly in patients with cardiovascular disease.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 345-356"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812582","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":"Inflammation in Focus","authors":"Médéa Locquet PhD ,&nbsp;Gaëlle Jimenez MD ,&nbsp;Jean Ferrières MD, PhD ,&nbsp;Georges Tarlet MS ,&nbsp;Matthieu Lapeyre MD ,&nbsp;Rodrigue Allodji PhD ,&nbsp;Jérémy Camilleri PhD ,&nbsp;David Broggio PhD ,&nbsp;Florent De Vathaire MD, PhD ,&nbsp;Fabien Milliat PhD ,&nbsp;Sophie Jacob PhD","doi":"10.1016/j.jaccao.2025.05.001","DOIUrl":"10.1016/j.jaccao.2025.05.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 445-447"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306563","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":"Correlation of Natriuretic Peptides with Invasively Measured Intracardiac Filling Pressures in Patients With Cancer","authors":"Mariya M. Fatakdawala MD ,&nbsp;Hyeon-Ju Ryoo Ali MD ,&nbsp;Juhee Song PhD ,&nbsp;Jorge A. Irizarry-Caro MD ,&nbsp;Saadia A. Faiz MD ,&nbsp;Salil Kumar MD ,&nbsp;Syed Wamique Yusuf MBBS ,&nbsp;Jean-Bernard Durand MD ,&nbsp;Cezar Iliescu MD ,&nbsp;Nicolas Palaskas MD, MPH ,&nbsp;Anita Deswal MD, MPH ,&nbsp;Efstratios Koutroumpakis MD","doi":"10.1016/j.jaccao.2025.03.006","DOIUrl":"10.1016/j.jaccao.2025.03.006","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 448-450"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046669","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":"Breaking the One-Size-Fits-All Approach in Cardio-Oncology","authors":"Hiroshi Ohtsu PhD, MSc ,&nbsp;Akihiko Shimomura MD, PhD ,&nbsp;Kazuhiro Sase MD, PhD","doi":"10.1016/j.jaccao.2025.05.007","DOIUrl":"10.1016/j.jaccao.2025.05.007","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 442-444"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307770","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":"Orthostatic Intolerance After Hematopoietic Stem Cell Transplantation","authors":"Jacquie R. Baker PhD ,&nbsp;Andrew Daly MD ,&nbsp;Satish R. Raj MD, MSCI","doi":"10.1016/j.jaccao.2025.05.008","DOIUrl":"10.1016/j.jaccao.2025.05.008","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 393-395"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308059","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":"Synergistic miRNA Combinations Mitigate Doxorubicin-Induced Cardiotoxicity","authors":"Pilar Sepúlveda PhD","doi":"10.1016/j.jaccao.2025.04.002","DOIUrl":"10.1016/j.jaccao.2025.04.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 411-413"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308060","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":"Cardiac Biomarkers in Patients With Suspected Amyloid (Transthyretin) Cardiomyopathy","authors":"Alberto Aimo MD, PhD,&nbsp;Vincenzo Castiglione MD,&nbsp;Giuseppe Vergaro MD, PhD,&nbsp;Michele Emdin MD, PhD","doi":"10.1016/j.jaccao.2025.02.007","DOIUrl":"10.1016/j.jaccao.2025.02.007","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Page 451"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307898","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":"Effects of Aerobic Exercise on Cardiorespiratory Fitness and Cardiovascular Risk Factors in Long-Term Breast Cancer Survivors","authors":"Sara H. Johansen MSc ,&nbsp;Mali Sæter MD ,&nbsp;Sebastian I. Sarvari MD, PhD ,&nbsp;Kristin V. Reinertsen MD, PhD ,&nbsp;Elisabeth Edvardsen PhD ,&nbsp;Torbjørn Wisløff PhD ,&nbsp;Jessica M. Scott PhD ,&nbsp;May Grydeland PhD ,&nbsp;Truls Raastad PhD ,&nbsp;Jostein Hallén PhD ,&nbsp;Cecilie E. Kiserud MD, PhD ,&nbsp;Hanne C. Lie PhD ,&nbsp;Paul A. Solberg PhD ,&nbsp;Kristina Hermann Haugaa MD, PhD ,&nbsp;Johanne S.S. Jensen MSc ,&nbsp;Line H. Vatningen MSc ,&nbsp;Lene Thorsen PhD ,&nbsp;Tormod S. Nilsen PhD","doi":"10.1016/j.jaccao.2025.04.006","DOIUrl":"10.1016/j.jaccao.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Cancer treatment may impair physiological adaptations to exercise therapy, yet no study has directly compared exercise effects between cancer survivors and cancer-naive control subjects.</div></div><div><h3>Objectives</h3><div>This study sought to examine the effects of aerobic exercise in anthracycline-treated long-term survivors of breast cancer (BCS) and to compare the effects to cancer-naive women.</div></div><div><h3>Methods</h3><div>The CAUSE (CArdiovascUlar Survivors Exercise) trial was a 2-arm randomized controlled trial in which long-term BCS were assigned to thrice-weekly nonlinear aerobic exercise for 5 months (BCS exercise) or usual care (BCS usual care). A third group of similarly aged cancer-naive women completed the same exercise intervention. The primary outcome was cardiorespiratory fitness (CRF) (measured as <span><math><mrow><mi>V</mi></mrow></math></span><span>o</span>_{<span>2</span>peak}). Secondary outcomes included cardiovascular risk factors (cardiometabolic biomarkers and body composition) and patient-reported outcomes (subjective vitality and life satisfaction).</div></div><div><h3>Results</h3><div>Between October 2020 and February 2023, 140 BCS (aged 59.0 ± 6.4 years; 11 ± 1 years after treatment) and 69 cancer-naive women (aged 57.8 ± 4.9 years) were enrolled. From baseline to post-exercise intervention, V<span>o</span>_{<span>2</span>peak} increased by 1.2 ± 2.6 mL·kg⁻¹·min⁻¹ in the BCS exercise, by 0.01 ± 2.5 mL·kg⁻¹·min⁻¹ in the BCS usual care group (mean difference 1.3; 95% confidence interval [CI]: 0.5-2.1; <em>P</em> = 0.002), and by 2.6 ± 2.5 mL·kg⁻¹·min⁻¹ in non-cancer subjects (BCS exercise vs non-cancer subjects: mean difference −1.4; 95% CI: −2.2 to −0.5; <em>P</em> = 0.003). No changes in cardiovascular risk factors were observed. Compared with BCS usual care, the BCS exercise group reported improved subjective vitality (mean difference 2.56; 95% CI: 1.22-3.90; <em>P</em> &lt; 0.001) and satisfaction with life (mean difference 1.68; 95% CI: 0.43-2.93; <em>P</em> = 0.009).</div></div><div><h3>Conclusions</h3><div>Although aerobic exercise improves CRF in anthracycline-treated long-term BCS, the response was less than one-half that observed in cancer-naive subjects.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 414-426"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308061","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":"Exercise Training in Breast Cancer Survivors","authors":"Simon Wernhart MD, PhD ,&nbsp;Caterina Fiorentini MD ,&nbsp;Martin Halle MD","doi":"10.1016/j.jaccao.2025.05.004","DOIUrl":"10.1016/j.jaccao.2025.05.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 427-429"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308062","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":"Cardiac Safety of Reduced Cardiotoxicity Surveillance During HER2-Targeted Therapy","authors":"Anthony F. Yu MD, MS ,&nbsp;Chau T. Dang MD ,&nbsp;Chaya S. Moskowitz PhD ,&nbsp;Akriti Mishra Meza MS ,&nbsp;Patricia DeFusco MD ,&nbsp;Eric Oligino MD ,&nbsp;Carol L. Chen MD ,&nbsp;Rachel Sanford MD ,&nbsp;Pamela Drullinsky MD ,&nbsp;Jacqueline Bromberg MD, PhD ,&nbsp;Serena Wong MD ,&nbsp;Shanu Modi MD ,&nbsp;Justine Jorgensen BS ,&nbsp;Kevin C. Oeffinger MD ,&nbsp;Richard M. Steingart MD ,&nbsp;Jennifer E. Liu MD","doi":"10.1016/j.jaccao.2025.05.006","DOIUrl":"10.1016/j.jaccao.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Echocardiograms are recommended every 3 months to monitor for cancer therapy–related cardiac dysfunction (CTRCD) among patients treated with HER2-targeted therapy, despite increasing use of safer regimens associated with low CTRCD risk.</div></div><div><h3>Objectives</h3><div>This study evaluated the cardiac safety of reduced CTRCD surveillance performed every 6 months during non-anthracycline HER2-targeted treatment.</div></div><div><h3>Methods</h3><div>This non-randomized clinical trial enrolled 190 patients with HER2-positive breast cancer treated with non-anthracycline HER2-targeted therapy. CTRCD surveillance by means of echocardiography was performed every 6 months. Key exclusion criteria were previous anthracycline exposure, significant cardiovascular disease, and uncontrolled hypertension. The primary outcome was the cardiac event rate, defined by heart failure or cardiovascular death at 1 year. Secondary outcomes included change in LVEF from baseline to 6 months and 1 year, incidence of asymptomatic CTRCD, incidence of HER2-targeted treatment interruption, and feasibility of reduced cardiac surveillance.</div></div><div><h3>Results</h3><div>The median age was 52 years (Q1-Q3: 45-60 years); 174 (91.6%) had stage I-III disease, and all were treated with a trastuzumab-based regimen. Cardiovascular risk factors included hypertension (20.0%) and diabetes (4.2%), and the mean left ventricular ejection fraction at baseline was 63.6 ± SE 0.3%. There were 0 (0%; 1-sided 97.5% CI: 0%-1.9%) cardiac events with a median follow-up of 17.5 months (Q1-Q3: 16.3-18.9 months). One patient developed asymptomatic CTRCD (0.5%; 95% CI: 0.01%-2.9%) but resumed therapy after a temporary treatment interruption. Adherence to the reduced CTRCD surveillance schedule every 6 months was 73.2% (intention-to-treat) and 79.9% (per-protocol).</div></div><div><h3>Conclusions</h3><div>Reduced CTRCD surveillance every 6 months is safe and feasible for patients at low risk for CTRCD and may be an appropriate strategy to consider during non-anthracycline HER2-targeted treatment regimens.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 4","pages":"Pages 430-441"},"PeriodicalIF":12.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307771","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}