The emerging issue of cardiac dysfunction induced by antineoplastic angiogenesis inhibitors

Area of Science:

• Cardio-oncology
• Pharmacology
• Cardiovascular Medicine

Background:

• Anticancer therapies, including anthracyclines and targeted agents, can lead to cardiotoxicity.
• The increasing use of biological therapies and cancer survivorship highlights emerging cardiovascular concerns.
• Vascular Endothelial Growth Factor (VEGF) inhibitors represent a significant class of anticancer drugs with potential cardiovascular side effects.

Purpose of the Study:

• To review the mechanisms and pathophysiology of cardiotoxicity induced by antiangiogenic drugs.
• To focus on left ventricular (LV) dysfunction as a key adverse effect.
• To discuss the assessment and management of VEGF inhibitor-induced cardiotoxicity based on current cardio-oncology and heart failure guidelines.

Main Methods:

• Literature review of mechanisms and pathophysiology of antiangiogenic drug cardiotoxicity.
• Analysis of clinical findings related to VEGF inhibitors and cardiovascular effects.
• Synthesis of current cardio-oncology and heart failure guidelines for assessment and management.

Main Results:

• VEGF signaling is critical for vascular growth and myocardial function.
• Antiangiogenic drugs, often multi-targeted, can cause a range of cardiovascular side effects, including LV dysfunction.
• Specific attention is given to the cardiotoxic effects of VEGF inhibitors.

Conclusions:

• Antiangiogenic drugs, particularly VEGF inhibitors, pose a significant risk of left ventricular dysfunction.
• Understanding the mechanisms and pathophysiology is crucial for effective management.
• Current guidelines provide a framework for assessing and managing these cardiotoxic effects in cancer survivors.