Cardio-oncology最新文献

{"title":"The effects of sodium-glucose cotransporter-2 inhibitors in chemotherapy-induced cardiotoxicity and mortality in patients with cancer: a systematic review and meta-analysis.","authors":"Tara Reshadmanesh, Reza Mohebi, Amir Hossein Behnoush, Azadeh Reshadmanesh, Amirmohammad Khalaji, Mitra Norouzi, Elmira Javanmardi, Reza Pishdad, S Reza Jafarzadeh, Elina Ghondaghsaz, Sandra Chaparro","doi":"10.1186/s40959-025-00343-4","DOIUrl":"https://doi.org/10.1186/s40959-025-00343-4","url":null,"abstract":"<p><strong>Background: </strong>The effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on reducing cardiovascular events in different subgroups of diabetic patients are under investigation. The current systematic review and meta-analysis investigated the effects of SGLT2 inhibitors on preventing cardiovascular events and mortality and their adverse events in patients with active cancer and diabetes undergoing cardiotoxic cancer treatment.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and Scopus to find studies investigating the effects of SGLT2 inhibitors on patients with diabetes and confirmed cancer until 19 August 2024. Meta-analyses were conducted using the random-effects model to compare all-cause mortality, cancer-associated mortality, heart failure (HF) hospitalization, arrhythmia, and adverse event rates such as ketoacidosis, hypoglycemia, urinary tract infection, and sepsis between patients with or without SGLT2 inhibitors use. Risk ratios (RRs) with 95% confidence intervals (CI) were used to compare outcomes between SGLT2 inhibitors and non-SGLT2 inhibitors groups.</p><p><strong>Results: </strong>Eleven studies were included with 88,096 patients with confirmed cancer (49% male). Among the total population, 20,538 received SGLT2 inhibitors (age 61.68 ± 10.71), while 67,558 did not receive SGLT2 inhibitors (age 68.24 ± 9.48). The meta-analysis found that the patients who received SGLT2 inhibitors had a significantly lower mortality rate than those who did not receive SGLT2 inhibitors (RR 0.46, 95% CI 0.34 to 0.63, p-value < 0.0001). Similarly, the cancer-associated mortality rate was also lower (RR 0.29, 95% CI 0.27 to 0.30, p-value < 0.0001). Further analysis found that the SGLT2 inhibitor group had a lower rate of HF hospitalization, compared to controls (RR 0.44, 95% CI 0.27 to 0.70, p-value = 0.0007). Moreover, patients receiving SGLT2 inhibitors had a statistically lower rate of arrhythmia (RR 0.38, 95% CI 0.26 to 0.56, p-value < 0.0001). Finally, patients in the SGLT2 inhibitors group had a lower rate of adverse events (RR 0.51, 95% CI 0.42 to 0.62, p-value < 0.0001).</p><p><strong>Conclusions: </strong>SGLT2 inhibitors are effective in reducing mortality (all-cause and cancer-associated), HF hospitalization, arrhythmia, and drug adverse events in patients with cancer. If confirmed in future studies, these agents could be a potentially ideal candidate to prevent cardiotoxicity of cancer therapies.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"50"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning for cardio-oncology: predicting global longitudinal strain from conventional echocardiographic measurements in cancer patients.","authors":"Tagayasu Anzai, Kenji Hirata, Ken Kato, Kohsuke Kudo","doi":"10.1186/s40959-025-00348-z","DOIUrl":"10.1186/s40959-025-00348-z","url":null,"abstract":"<p><strong>Introduction: </strong>Global longitudinal strain (GLS) is an important prognostic indicator for predicting heart failure and cancer therapy-related cardiac dysfunction (CTRCD). Although access to GLS measurement has increased across institutions, its actual use in clinical practice remains limited due to practical barriers such as limited time and insufficient training. If reduced GLS could be predicted from conventional echocardiographic parameters, it could help identify patients who would most benefit from direct GLS assessment. Therefore, in this study, we tested the hypothesis that reduced GLS can be predicted from conventional echocardiography via a machine learning (ML) approach.</p><p><strong>Methods: </strong>This single-center cross-sectional study included patients who visited the Tokyo Metropolitan Tama Medical Center Hospital and underwent echocardiography with GLS before or after anticancer chemotherapy. Low-GLS was defined as a GLS < 16; otherwise, it was defined as Normal-GLS. Patients with EF < 50% were excluded. We developed ML models that predict Low-GLS from conventional echocardiography measurements. Sixteen ML models were constructed including various boosting and tree-based methods. We assessed the models by the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV), and F1 score. The Shapley Additive exPlanations (SHAP) method was employed to evaluate the essential predictors.</p><p><strong>Results: </strong>A total of 1,484 patients (64 ± 13 years old, 69% female) were enrolled for ML model development, including 406 patients with Low-GLS and 1,078 with Normal-GLS. The best model for the test dataset was the CatBoost classifier (AUC, 0.748; accuracy, 0.734). Diastolic dysfunction indices [such as septal/lateral mitral annular early diastolic velocity (e') and E-wave to atrial contraction filling velocity (E/A)] and peak velocity‑related parameters [aortic valve peak velocity (AV-Vmax) and left ventricular outflow tract velocity maximum (LVOT-Vmax)] played essential roles in the Low-GLS prediction model.</p><p><strong>Conclusion: </strong>This study indicated the possibility that Low-GLS might be predicted by machine learning models from conventional echocardiography measurements in cancer patients.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"49"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary prevention of cardiotoxicity in cancer patients treated with fluoropyrimidines: a randomized controlled trial.","authors":"Johanne D Lyhne, Vibeke B Hansen, Lone D Vestergaard, Susanne E Hosbond, Martin Busk, Mayooran Gnanaganesh, Else Maae, Birgitte M Havelund, Torben F Hansen, Signe Timm, Lars H Jensen, Mads D Lyhne","doi":"10.1186/s40959-025-00344-3","DOIUrl":"10.1186/s40959-025-00344-3","url":null,"abstract":"<p><strong>Background: </strong>Fluoropyrimidines (FP) are the third most used chemotherapeutic drugs administered in solid tumors but have cardiotoxic side effects. We aimed to determine whether pre-chemotherapeutic cardiological assessment and management of cardiovascular risk factors could prevent FP-induced cardiotoxicity and if the coronary artery calcium (CAC) score was predictive of chest pain.</p><p><strong>Methods: </strong>This was a randomized, controlled, single center trial of patients with various cancer types who were treated with FP and had no known ischemic heart disease. All patients had CAC score obtained by cardiac CT scan. Patients were randomized to pre-chemotherapeutic cardiological management or standard care. Cardiological management included risk reduction based on electro- and echocardiographic evaluation and blood samples. Primary composite endpoint included hospital admission for chest pain, acute coronary syndrome, coronary angiography intervention, or all-cause mortality. Secondary outcome was chest pain. Follow-up was 6 months. Data were analyzed using Kaplan-Meier survival function with log-rank test and ROC-analyses.</p><p><strong>Results: </strong>Of the 192 patients included, the primary endpoint occurred in 9/95 (9.5%) patients in the intervention group and 15/97 (15.5%) patients in the control group (log-rank p = 0.19) with an incidence rate ratio (IRR) of 0.57 (95% CI [0.22 - 1.39]). Chest pain occurred in 6/95 (6.3%) patients in the intervention group and 13/97 (13.4%) in the control group, yielding an IRR of 0.44 (95% CI [0.14 - 1.23]). CAC score did not predict chest pain occurrence.</p><p><strong>Conclusions: </strong>Cardiological management of cardiovascular risk factors prior to treatment with fluoropyrimidines resulted in half as many cardiotoxic events but the study did not reach statistical significance. Further studies are needed to investigate the optimal strategies to prevent fluoropyrimidine-induced cardiotoxicity in cancer patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifyer NCT03486340.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"48"},"PeriodicalIF":3.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative mRNA splicing in anthracycline-induced cardiomyopathy - a COG-ALTE03N1 report.","authors":"Purnima Singh, David K Crossman, Changde Cheng, Patrick J Trainor, Noha Sharafeldin, Xuexia Wang, Liting Zhou, Lindsey Hageman, Saro H Armenian, Frank M Balis, Douglas S Hawkins, Frank G Keller, Melissa M Hudson, Joseph P Neglia, Jill P Ginsberg, Wendy Landier, Smita Bhatia","doi":"10.1186/s40959-025-00345-2","DOIUrl":"10.1186/s40959-025-00345-2","url":null,"abstract":"<p><strong>Background: </strong>Anthracycline-induced cardiomyopathy is a well-established adverse consequence in childhood cancer survivors. Altered mRNA expression in the peripheral blood has been found at the level of genes and pathways among anthracycline-exposed childhood cancer survivors with and without cardiomyopathy. However, the role of aberrant alternative splicing in anthracycline-induced cardiomyopathy remains unexplored. The present study examined if transcript-specific events, due to alternative splicing occur in anthracycline-exposed childhood cancer survivors with and without cardiomyopathy.</p><p><strong>Methods: </strong>Participants were anthracycline-exposed childhood cancer survivors with cardiomyopathy (cases) matched with anthracycline-exposed childhood cancer survivors without cardiomyopathy (controls; matched on primary cancer diagnosis, year of diagnosis, and race/ethnicity). mRNA sequencing was performed on total RNA from peripheral blood in 32 cases and 32 matched controls. Event-level splicing tool, rMATS (replicate Multivariate Analysis of Transcript Splicing) was used for quantitative profiling of alternative splicing events.</p><p><strong>Results: </strong>A total of 45 alternative splicing events in 36 genes were identified. Using a prioritization strategy to filter the alternative splicing events, intron retention in RPS24 and skipped exon of PFND5 showed differential expression of altered transcripts.</p><p><strong>Conclusions: </strong>We identified specific alternative splicing events in anthracycline-exposed childhood cancer survivors with and without cardiomyopathy. Our findings suggest that differential alternative splicing events can provide additional insight into the peripheral blood transcriptomic landscape of anthracycline-induced cardiomyopathy.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"47"},"PeriodicalIF":3.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an early prediction model for cardiac death risk in patients with light chain amyloidosis: a multicenter study.","authors":"Naidong Pang, Ying Tian, Hongjie Chi, Xiaohong Fu, Xin Li, Shuyu Wang, Feifei Pan, Dongying Wang, Lin Xu, Jingyi Luo, Aijun Liu, XingPeng Liu","doi":"10.1186/s40959-025-00342-5","DOIUrl":"10.1186/s40959-025-00342-5","url":null,"abstract":"<p><strong>Background: </strong>Cardiac involvement is the primary driver of death in systemic light chain (AL) amyloidosis. However, the early prediction of cardiac death risk in AL amyloidosis remains insufficient.</p><p><strong>Objectives: </strong>We aimed to develop a novel prediction model and prognostic scoring system that enables early identification of these high-risk individuals.</p><p><strong>Methods: </strong>This study enrolled 235 patients with confirmed AL cardiac amyloidosis from three hospitals. Patients from the first hospital were randomly assigned to the training and internal validation sets in an 8:2 ratio, while the external validation set comprised patients from the other two hospitals. Participants were categorized into a cardiac death group and a non-cardiac death group (including survivors and those who died from other causes). Five different machine learning models were used to train model, and model performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis.</p><p><strong>Results: </strong>All five models showed excellent performance on the training and internal validation sets. In external validation, both the Logistic Regression (LR) and Random Forest models achieved an area under the ROC curve of 0.873 and 0.877, respectively, and exhibited superior calibration and decision curve analysis. Considering the comprehensive performance and clinical applicability, the LR model was selected as the final prediction model. The visualization results are ultimately presented in a nomogram. Further analyses were performed on the newly identified predictors.</p><p><strong>Conclusions: </strong>This prediction model enables early identification and risk assessment of cardiac death in patients with AL amyloidosis, exhibiting considerable predictive ability.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"45"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hospital variation in hematologic malignancy patient proportions on outcomes of chronic lymphocytic leukemia patients undergoing cardiac surgery: insights from nationwide data analysis.","authors":"Meizhen Yi, Lanxin Hu, Jifang Zhou, Yali Ge, Cunhua Su, Fan Yang","doi":"10.1186/s40959-025-00326-5","DOIUrl":"10.1186/s40959-025-00326-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the impact of the proportion of hematologic malignancy patients in hospitals on the prognosis of chronic lymphocytic leukemia (CLL) patients undergoing cardiac surgery. Perioperative management of CLL patients is complex, particularly regarding immunosuppression and infection risks.</p><p><strong>Methods: </strong>This retrospective study utilized data from the National Inpatient Sample (NIS) from 2010 to 2021. Adult CLL patients undergoing cardiac surgery were included, categorizing hospitals into five quintiles based on hematologic malignancy patient proportions. Outcomes included in-hospital mortality, acute kidney injury (AKI), postoperative bleeding, and infections.</p><p><strong>Results: </strong>AKI incidence was significantly lower in the Q5 group (OR: 0.68, 95% CI: 0.49-0.97), as was the rate of respiratory failure (OR: 0.53, 95% CI: 0.35-0.79). However, the rates of transfusion and acute heart failure were significantly higher in Q5 (acute heart failure OR: 1.70, 95% CI: 1.07-2.77). No significant differences were found in in-hospital mortality or other complications.</p><p><strong>Conclusion: </strong>The proportion of hematologic malignancy patients affects CLL patient outcomes, with higher proportions linked to lower AKI and respiratory failure rates but increased transfusion and heart failure risks. Further research is warranted.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"46"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methylation-based biological age and cardiotoxicity risk in breast cancer patients treated with trastuzumab.","authors":"Jamila Mammadova, Alicia Richards, Adriana Gonzalez-Torriente, Evan R Adler, Rachel J Cruz, Stefanie Palfi, Dae Hyun Lee, Christine Sam, Mohammed Al-Jumayli, Anders Berglund, Jong Y Park, Mohammed Alomar, Jacob K Kresovich","doi":"10.1186/s40959-025-00340-7","DOIUrl":"https://doi.org/10.1186/s40959-025-00340-7","url":null,"abstract":"<p><strong>Background: </strong>Trastuzumab is an effective treatment for HER2-positive cancers that has known cardiotoxic properties. Discovering biomarkers that assess cardiotoxicity risk before trastuzumab therapy is essential for protecting the cardiovascular health of cancer patients.</p><p><strong>Objective: </strong>To examine the associations between pre-treatment epigenetic age acceleration, circulating leukocyte composition, and candidate single nucleotide polymorphisms (SNPs) with cardiotoxicity risk in breast cancer patients receiving trastuzumab.</p><p><strong>Methods: </strong>Among a retrospective cohort of HER2-positive breast cancer patients treated with trastuzumab at Moffitt Cancer Center, we profiled blood DNA methylation and genetic profiles. Epigenetic clocks and circulating leukocyte subsets were derived from MethylationEPIC BeadChip data, and candidate SNPs were measured using the Global Screening Array. Cardiotoxicity events (i.e., reductions in left ventricular ejection fraction, symptomatic heart failure), were identified in medical records. Logistic regression models, adjusted for traditional risk factors, estimated odds ratios (ORs) for biomarker associations with cardiotoxicity risk.</p><p><strong>Results: </strong>Among 157 patients selected for this study, 39 (25%) experienced cardiotoxicities within one year of treatment initiation. rs776746 was inversely associated with cardiotoxicity risk (OR: 0.38, 95% CI: 0.14, 1.00, P = 0.05). After adjusting for traditional risk factors and leukocyte composition, the Hannum AgeAccel, Horvath AgeAccel, and Horvath Skin and Blood AgeAccel metrics were significantly positively associated with cardiotoxicity risk (ORs ranging between 1.62 and 1.89). Adding Horvath Skin and Blood AgeAccel to traditional cardiotoxicity risk factors significantly improved cardiotoxicity risk prediction (AUC: 0.75 vs. 0.79; P-diff = 0.04).</p><p><strong>Conclusions: </strong>Pre-treatment epigenetic age acceleration appears to be a novel biomarker for cardiotoxicity risk that improves cardiotoxicity risk prediction.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"44"},"PeriodicalIF":3.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-oncology care in Africa: current trends and disparities.","authors":"Princess Afia Nkrumah-Boateng, Adam Ben-Jaafar, Allswell Naa Adjeley Boye, Pearl Ohenewaa Tenkorang, Toufik Abdul-Rahman, Wireko Andrew Awuah","doi":"10.1186/s40959-025-00341-6","DOIUrl":"https://doi.org/10.1186/s40959-025-00341-6","url":null,"abstract":"<p><p>The emerging discipline of cardio-oncology addresses the cardiovascular complications associated with cancer therapies. In sub-Saharan Africa (SSA), where both cardiovascular disease (CVD) and cancer-related mortality are increasing, the development of cardio-oncology services remains limited. This correspondence assesses the current state of cardio-oncology in Africa, highlighting significant gaps in infrastructure, workforce, and policy. Despite the establishment of a single accredited cardio-oncology unit in South Africa, formalized services are lacking in the majority of African countries, leading to fragmented care and increased incidence of treatment-related cardiotoxicity. Key barriers include inadequate specialist training, limited diagnostic resources and a lack of standardized care protocols. The paper outlines strategic interventions, including multidisciplinary training, integration of cardiovascular screening into oncology, research funding, and policy reform. Strengthening cardio-oncology services is essential to reduce the dual burden of cancer and CVD and improve clinical outcomes for affected populations in SSA.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"43"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Heart Failure Induced by Doxorubicin with Early Administration of Dexrazoxane (PHOENIX Study): dose response and time course of dexrazoxane-induced degradation of topoisomerase 2b.","authors":"Hui-Ming Chang, Jinn-Yuan Hsu, Chul Ahn, Edward T H Yeh","doi":"10.1186/s40959-025-00339-0","DOIUrl":"https://doi.org/10.1186/s40959-025-00339-0","url":null,"abstract":"<p><strong>Background: </strong>Dexrazoxane, a putative iron chelator, is effective in preventing doxorubicin-induced cardiotoxicity. However, dexrazoxane is also a catalytic inhibitor of topoisomerase 2b (Top2b), a key mediator of doxorubicin toxicity. Preclinical studies have shown that dexrazoxane induces Top2b degradation, and early administration (8 h before doxorubicin) can prevent doxorubicin-induced cardiotoxicity. In this study, we investigated the dose-response relationship and time course of dexrazoxane-induced Top2b degradation in human volunteers.</p><p><strong>Methods: </strong>Twenty-five healthy female volunteers received an intravenous infusion of dexrazoxane at doses ranging from 100 mg/m² to 500 mg/m². Blood samples were collected hourly from time zero to 12 h, as well as at 24- and 48-h post-infusion. Peripheral blood mononuclear cells (PBMCs) were isolated, nuclear fractions were extracted, and Top2b expression was analyzed by western blot using Lamin B1 as a control. A linear mixed-effects model was used to assess differences among the five dose groups.</p><p><strong>Results: </strong>Dexrazoxane infusion led to a rapid and sustained reduction of Top2b in PBMCs, lasting up to 12 h. Statistical analysis revealed a significant difference in Top2b levels among the five dose groups (p = 0.0002). Subgroup analysis identified a significant difference between the 100 mg/m² and 500 mg/m² groups (p = 0.005). However, topoisomerase 2a (Top2a), the molecular target of doxorubicin's tumor-killing effect, remained unchanged following dexrazoxane infusion.</p><p><strong>Conclusions: </strong>Findings from this dose-response and time-course study can inform the design of future clinical trials investigating the efficacy of early dexrazoxane administration in preventing doxorubicin-induced cardiotoxicity while minimizing the risk of tumor protection.</p><p><strong>Trial registration: </strong>(Funded by the National Institute of Health, RO1HL151993; PHOENIX trials, ClinicalTrials.gov number, NCT03930680.).</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"42"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac benign metastatic leiomyoma- a comprehensive review.","authors":"Pankaj Garg, Mostafa Ali, Mohammad Alomari, J Kenneth Schoolmeester, Mark Edgar, Carolyn K Landolfo, Steven Attia, Kevin P Landolfo","doi":"10.1186/s40959-025-00336-3","DOIUrl":"https://doi.org/10.1186/s40959-025-00336-3","url":null,"abstract":"<p><p>Cardiac benign metastatic leiomyoma (BML) is a rare cardiac tumor that is usually asymptomatic, frequently misdiagnosed and may result in serious complications, including embolization, heart failure and death. This review highlights the importance of considering cardiac BML in the differential diagnosis of cardiac masses, especially in women with a history of uterine leiomyomas. This review summarizes the current knowledge about cardiac BML, including its demographics, clinical presentation, etio-pathogenesis, diagnosis, and management. The authors discuss the challenges associated with diagnosing cardiac BML and emphasize the importance of a thorough history, physical examination, and imaging studies. They also review the different treatment options for cardiac BML, including surgical resection and role of medical and surgical castration. Early diagnosis and management of cardiac BML is crucial to prevent complications. This review provides valuable insights for clinicians who may encounter this rare condition. By raising awareness of cardiac BML and its management strategies, this review can improve patient care and outcomes.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"41"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}