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Epigenetic Changes Associated With Anthracycline-Induced Cardiotoxicity.

Marwa Tantawy1,2, Frances G Pamittan1, Sonal Singh3

  • 1Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA.

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Anthracycline chemotherapy can cause heart damage (cardiotoxicity), leading to heart failure years after treatment. Understanding these epigenetic effects is crucial for cardio-oncology patient care.

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Area of Science:

  • Cardio-Oncology
  • Cancer Therapeutics
  • Molecular Cardiology

Background:

  • Cancer treatments improve survival but cause long-term complications like cardiotoxicity.
  • Cardio-Oncology is an emerging field addressing cardiovascular care in cancer patients.
  • Anthracyclines are vital chemotherapeutics with dose-limiting cardiotoxicity, known as anthracycline-induced cardiotoxicity (AIC).

Purpose of the Study:

  • To provide an overview of cardiotoxicity, specifically focusing on anthracyclines.
  • To elucidate the molecular and epigenetic mechanisms underlying anthracycline-induced cardiotoxicity.
  • To highlight the clinical significance of AIC in cancer survivors.

Main Methods:

  • Review of existing literature on anthracycline-induced cardiotoxicity.
  • Analysis of proposed pathophysiological mechanisms of AIC.
  • Exploration of epigenetic modifications in relation to cardiotoxicity.

Main Results:

  • AIC can manifest as early-onset (within 1 year) or late-onset cardiotoxicity (up to decades post-treatment).
  • Pathophysiology involves reactive oxygen species, lipid peroxidation, mitochondrial dysfunction, and DNA damage in cardiomyocytes.
  • Anthracycline metabolites contribute to mitochondrial damage, apoptosis, arrhythmias, and contractile dysfunction.

Conclusions:

  • Anthracycline-induced cardiotoxicity poses a significant clinical challenge, impacting long-term cancer patient survival.
  • Epigenetic mechanisms are integral to understanding and potentially mitigating AIC.
  • Further research into AIC's molecular pathways is essential for advancing cardio-oncology.