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Androgen deprivation therapy and cardiovascular complications
Abstract:
Cardiovascular complications associated with the use of antiandrogens have already been known for some time. Based on the results of the latest meta-analyses and clinical studies published in the last few years, the attention of the scientific community is focused on the deleterious cardiovascular effects of gonadotropine-releasing hormon agonists in context of the androgen deprivating therapy. The cardiac toxicity is a problem especially in patients with preexisting cardiovascular comorbidities. Increased arterial wall thickening along with endothelial dysfunction has been observed in patients with descreased androgens levels in the peripheral blood. The treatment with gonadotropine-releasing hormon agonists may disrupt the intracellular concentration of calcium ions and the contractile process and potentially result in pathological remodelling of heart. Here, we give several possible mechanisms of action of gonadotropine-releasing hormon agonists on the cardiovascular system that may be a potential explanation of the clinical observations (Ref. 44).
Insights
Gonadotropin-releasing hormone agonists used in androgen deprivation therapy can harm the heart, especially in patients with existing cardiovascular issues. This may involve arterial thickening and disrupted heart function.
Area of Science:
- Cardiology
- Endocrinology
- Oncology
Background:
- Cardiovascular complications are known side effects of antiandrogen therapies.
- Recent research highlights the cardiovascular risks of gonadotropin-releasing hormone (GnRH) agonists in androgen deprivation therapy (ADT).
Purpose of the Study:
- To explore potential mechanisms by which GnRH agonists may adversely affect the cardiovascular system.
- To explain observed clinical findings linking GnRH agonists to cardiac toxicity.
Main Methods:
- Review of recent meta-analyses and clinical studies.
- Analysis of proposed molecular and cellular pathways.
- Correlation of androgen levels with cardiovascular changes.
Main Results:
- GnRH agonist treatment may lead to arterial wall thickening and endothelial dysfunction.
- Disruption of intracellular calcium ions and contractile processes is a potential effect.
- Pathological cardiac remodeling may occur due to these disruptions.
Conclusions:
- GnRH agonists used in ADT pose cardiovascular risks, particularly for patients with pre-existing heart conditions.
- Understanding these mechanisms is crucial for managing cardiac toxicity in patients undergoing ADT.
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