scholarly journals Pathomechanisms and therapeutic opportunities in radiation-induced heart disease: from bench to bedside

2021 ◽  
Author(s):  
Márta Sárközy ◽  
Zoltán Varga ◽  
Renáta Gáspár ◽  
Gergő Szűcs ◽  
Mónika G. Kovács ◽  
...  
Keyword(s):  
Heart Disease ◽  
Survival Rates ◽  
Therapeutic Interventions ◽  
Term Survival ◽  
Normal Tissues ◽  
Cancer Management ◽  
Radiation Induced ◽  
Underlying Mechanisms ◽  
Oncology Practice ◽  
Molecular Pathomechanisms

AbstractCancer management has undergone significant improvements, which led to increased long-term survival rates among cancer patients. Radiotherapy (RT) has an important role in the treatment of thoracic tumors, including breast, lung, and esophageal cancer, or Hodgkin's lymphoma. RT aims to kill tumor cells; however, it may have deleterious side effects on the surrounding normal tissues. The syndrome of unwanted cardiovascular adverse effects of thoracic RT is termed radiation-induced heart disease (RIHD), and the risk of developing RIHD is a critical concern in current oncology practice. Premature ischemic heart disease, cardiomyopathy, heart failure, valve abnormalities, and electrical conduct defects are common forms of RIHD. The underlying mechanisms of RIHD are still not entirely clear, and specific therapeutic interventions are missing. In this review, we focus on the molecular pathomechanisms of acute and chronic RIHD and propose preventive measures and possible pharmacological strategies to minimize the burden of RIHD.

scholarly journals Impact of SARS-COV-2 Pandemic on Kidney Cancer Management

Kidney Cancer ◽  
2021 ◽  
pp. 1-14
Author(s):  
Melissa Bersanelli ◽  
Camillo Porta
Keyword(s):  
Survival Rates ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Cost Benefit ◽  
Original Data ◽  
Immune Checkpoint Blockade ◽  
Retrospective Case ◽  
Renal Masses ◽  
Term Survival ◽  
Cancer Management

Background: The SARS-CoV-2 pandemic still has a huge impact on the management of many chronic diseases such as cancer. Few data are presently available reagarding how the management of renal cell carcinoma (RCC) has changed due to this unprecedented situation. Objective: To discuss the challenges and issues of the diagnosis and treatment of RCC in the COVID-19 era, and to provide recommendations based on the collected literature and our personal experience. Methods: Systematic review of the available Literature regarding the management of RCC during the SARS-CoV-2 pandemic. Results: Our review showed a prevalence of narrative publications, raising the issue of the real relevance of the evidence retrieved. Indeed, the only original data about RCC and COVID-19 found were a small retrospective case series and two surveys, providing either patients’ or physicians’ viewpoints. Conclusions: The expected delayed diagnosis of RCC could lead to an increase of advanced/metastatic cases; thus, proper therapeutic choices for patients with small renal masses should be carefully evaluated case by case, in order to avoid negative effects on long-term survival rates. The controversial interaction between immune checkpoint blockade and COVID-19 pathogenesis is more hypothetical than evidence-based, and thus immunotherapy should not be denied, whenever appropriate. To avoid treatments which won’t have an impact on patients’ survival, a honest and accurate evaluation of the cost/benefit ratio of each treatment option should be always performed. Finally, SARS-CoV-2 swab positivity should not prevent the continuation of ongoing active treatments in asymptomatic cases, or or after symptoms’ resolution.

scholarly journals Long-term survival in patients with isolated pulmonary valve stenosis: a not so benign disease?

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001836
Author(s):  
Kristofer Skoglund ◽  
Annika Rosengren ◽  
Georgios Lappas ◽  
Maria Fedchenko ◽  
Zacharias Mandalenakis
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Diagnosis ◽  
Congenital Heart ◽  
Pulmonary Valve ◽  
Survival Rates ◽  
Pulmonary Valve Stenosis ◽  
Term Survival ◽  
Risk Of Mortality

Background and objectivesDuring the last decades, the survival rates in patients with congenital heart disease have increased dramatically, particularly in patients with complex heart malformations. However, the survival in patients with simple defects is still unknown. We aimed to determine the characteristics and the risk of mortality in patients with isolated pulmonary valve stenosis (PS).MethodsSwedish inpatient, outpatient and cause of death registries were used to identify patients born between 1970 and 2017 with a diagnosis of PS, without any other concomitant congenital heart lesion. For each patient with PS, 10 control individuals without congenital heart disease were matched by birth year and sex from the total population registry. We used median-unbiased method and Kaplan-Meier survival analysis to examine the risk of mortality.ResultsWe included 3910 patients with PS and 38 770 matched controls. The median age of diagnosis of PS was 0.7 years (IQR 0.3–7.0). During a median follow-up of 13.5 years (IQR 6.5–23.5), 88 patients with PS and 192 controls died; 500 patients with PS (12%) underwent at least one transcatheter or surgical valve intervention. The overall mortality rate was significantly higher in patients with PS compared with matched controls (HR 4.67, 95% CI 3.61 to 5.99, p=0.001). Patients with an early diagnosis of PS (0–1 year) had the highest risk of mortality (HR 10.99, 95% CI 7.84 to 15.45).ConclusionsIn this nationwide, register-based cohort study, we found that the risk of mortality in patients with PS is almost five times higher compared with matched controls. Patients with an early diagnosis of PS appears to be the most vulnerable group and the regular follow-up in tertiary congenital heart units may be the key to prevention.

scholarly journals Radiation-Induced Heart Disease: From Diagnosis to Prevention

2021 ◽  
Vol 7 (1) ◽  
pp. 31-35
Author(s):  
Budi Yuli Setianto ◽  
Andika Putra
Keyword(s):  
Heart Disease ◽  
Conduction System ◽  
Direct Effects ◽  
Pericardial Disease ◽  
Non Invasive ◽  
Accelerate Development ◽  
Drastic Increase ◽  
Radiation Induced ◽  
Artery Disease ◽  
Underlying Mechanisms

Radiotherapy has become an important component of multimodal treatment of malignancy. After 50 years, there was a drastic increase in outcomes of patients with malignancy. However, improvement of the survival is also accompanied by some inevitable complications on cardiovascular system which are often called radiation-induced heart disease (RIHD). RIHD comprises a spectrum of heart disease including pericardial disease, coronary artery disease, valvular heart disease, conduction system abnormalities, cardiomyopathy, and medium or large vessel vasculopathy. The underlying mechanisms include direct effects on function and structure of the heart, or accelerate development of cardiovascular disease, especially with the presence of previous cardiovascular risk factors. Recent studies have identified non-invasive methods for evaluation of RIHD. Furthermore, potential options preventing or at least attenuating RIHD have been developed. This review provides an overview of pathogenesis, clinical manifestation, diagnosis, management, and prevention of RIDH. Keywords: malignancy, radiotherapy, radiation - induced heart disease.

scholarly journals Short and Long-term Survival Rates following Myocardial Infarction and its Predictive Factors: A Study Using National Registry Data

2021 ◽  
Author(s):  
Samaneh Mozaffarian ◽  
Korosh Etemad ◽  
Mohammad Aghaali ◽  
Soheila Khodakarim ◽  
Sahar Sotoodeh Ghorbani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Predictive Factors ◽  
Survival Rates ◽  
Term Survival ◽  
Risk Of Death ◽  
Chronic Heart Disease ◽  
History Of ◽  
Short And Long Term

Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death. Conclusion: The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors.

scholarly journals Pathology and biology of radiation-induced cardiac disease

2016 ◽  
Vol 57 (5) ◽  
pp. 439-448 ◽  
Author(s):  
Soile Tapio
Keyword(s):  
Heart Disease ◽  
Ionizing Radiation ◽  
Cardiac Disease ◽  
Heart Tissue ◽  
Therapeutic Interventions ◽  
Cellular Mechanisms ◽  
Occupationally Exposed ◽  
Radiation Induced ◽  
Comprehensive Manner ◽  
Novel Targets

Abstract Heart disease is the leading global cause of death. The risk for this disease is significantly increased in populations exposed to ionizing radiation, but the mechanisms are not fully elucidated yet. This review aims to gather and discuss the latest data about pathological and biological consequences in the radiation-exposed heart in a comprehensive manner. A better understanding of the molecular and cellular mechanisms underlying radiation-induced damage in heart tissue and cardiac vasculature will provide novel targets for therapeutic interventions. These may be valuable for individuals clinically or occupationally exposed to varying doses of ionizing radiation.

scholarly journals LncRNA PCNAP1 Promotes Hepatoma Cell Proliferation through Targeting miR-340-5p and is Associated with Patient Survival

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Miao He ◽  
Lingjing Hu ◽  
Ping Bai ◽  
Tingting Guo ◽  
Nan Liu ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Noncoding Rna ◽  
Hepatoma Cell ◽  
Survival Rates ◽  
Poor Survival ◽  
Potential Therapeutic Target ◽  
Normal Tissues ◽  
Potential Biomarker ◽  
Underlying Mechanisms ◽  
Competitive Endogenous Rna

Hepatocellular carcinoma (HCC) is one of the most common malignancies and causes poor outcome. Dysregulation of long noncoding RNA (lncRNA) is involved in HCC. Upregulation of the lncRNA PCNAP1 has been reported to promote HBV-infectious HCC growth, but its clinical significance and underlying mechanisms in HCC development remain unclear. Here, we report that PCNAP1 expression is increased in both HBV-infectious and noninfectious HCC tissues compared with matched normal tissues, and its upregulation correlates with poor survival rates of HCC patients. Furthermore, we found that PCNAP1 promotes HCC cell proliferation through acting as a competitive endogenous RNA (ceRNA) to sponge miR-340-5p, which has been reported to directly inhibit ATF7 expression in HCC cells. Moreover, the PCNAP1/miR-340-5p/ATF7 signaling associates with the poor survival rates of HCC patients. Collectively, our findings suggest that the PCNAP1/miR-340-5p/ATF7 signaling may be a potential biomarker for the prognosis of HCC patients and a potential therapeutic target for HCC.

scholarly journals Comprehensive Analysis of a Nine-Gene Signature Related to Tumor Microenvironment in Lung Adenocarcinoma

2021 ◽  
Vol 9 ◽  
Author(s):  
Haihui Zhong ◽  
Jie Wang ◽  
Yaru Zhu ◽  
Yefeng Shen
Keyword(s):  
Lung Adenocarcinoma ◽  
Rna Sequencing ◽  
Molecular Mechanisms ◽  
Risk Model ◽  
Cox Regression ◽  
Survival Rates ◽  
Hub Genes ◽  
Term Survival ◽  
Cox Regression Analysis ◽  
Normal Tissues

Lung adenocarcinoma (LUAD) is the most common malignancy, leading to more than 1 million related deaths each year. Due to low long-term survival rates, the exploration of molecular mechanisms underlying LUAD progression and novel prognostic predictors is urgently needed to improve LUAD treatment. In our study, cancer-specific differentially expressed genes (DEGs) were identified using the robust rank aggregation (RRA) method between tumor and normal tissues from six Gene Expression Omnibus databases (GSE43458, GSE62949, GSE68465, GSE115002, GSE116959, and GSE118370), followed by a selection of prognostic modules using weighted gene co-expression network analysis. Univariate Cox regression, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses were applied to identify nine hub genes (CBFA2T3, CR2, SEL1L3, TM6SF1, TSPAN32, ITGA6, MAPK11, RASA3, and TLR6) that constructed a prognostic risk model. The RNA expressions of nine hub genes were validated in tumor and normal tissues by RNA-sequencing and single-cell RNA-sequencing, while immunohistochemistry staining from the Human Protein Atlas database showed consistent results in the protein levels. The risk model revealed that high-risk patients were associated with poor prognoses, including advanced stages and low survival rates. Furthermore, a multivariate Cox regression analysis suggested that the prognostic risk model could be an independent prognostic factor for LUAD patients. A nomogram that incorporated the signature and clinical features was additionally built for prognostic prediction. Moreover, the levels of hub genes were related to immune cell infiltration in LUAD microenvironments. A CMap analysis identified 13 small molecule drugs as potential agents based on the risk model for LUAD treatment. Thus, we identified a prognostic risk model including CBFA2T3, CR2, SEL1L3, TM6SF1, TSPAN32, ITGA6, MAPK11, RASA3, and TLR6 as novel biomarkers and validated their prognostic and predicted values for LUAD.

scholarly journals A Role of Glucose Overload in Diabetic Cardiomyopathy in Nonhuman Primates

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiu Wang ◽  
Shi Jin ◽  
Weina Hu
Keyword(s):  
Diabetic Cardiomyopathy ◽  
Nonhuman Primates ◽  
Survival Rates ◽  
Underlying Mechanism ◽  
Therapeutic Interventions ◽  
Cardiac Resynchronization ◽  
Altered Glucose ◽  
Increased Risk ◽  
Underlying Mechanisms ◽  
Poor Outcomes

Type 2 diabetes (T2D) plays a major role in the development of heart failure. Patients with T2D have an increased risk to develop HF than healthy subjects, and they always have very poor outcomes and survival rates. However, the underlying mechanisms for this are still unclear. To help develop new therapeutic interventions, well-characterized animal models for preclinical and translational investigations in T2D and HF are urgently needed. Although studies in rodents are more often used, the research findings in rodents have often failed to be translated into humans due to the significant metabolic differences between rodents and humans. Nonhuman primates (NHPs) serve as valuable translational models between basic studies in rodent models and clinical studies in humans. NHPs can recapitulate the natural progress of these diseases in humans and study the underlying mechanism due to their genetic similarity and comparable spontaneous T2D rates to humans. In this review, we discuss the importance of using NHPs models in understanding diabetic cardiomyopathy (DCM) in humans with aspects of correlations between hyperglycemia and cardiac dysfunction progression, glucose overload, and altered glucose metabolism promoting cardiac oxidative stress and mitochondria dysfunction, glucose, and its effect on cardiac resynchronization therapy with defibrillator (CRT-d), the currently available diabetic NHPs models and the limitations involved in the use of NHP models.

Outcome After Orthotopic Cardiac Transplantation in Adults With Congenital Heart Disease

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Jacqueline M. Lamour ◽  
Linda J. Addonizio ◽  
Mark E. Galantowicz ◽  
Jan M. Quaegebeur ◽  
Donna M. Mancini ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Transplantation ◽  
Congenital Heart ◽  
Myocardial Dysfunction ◽  
Survival Rates ◽  
Protein Losing Enteropathy ◽  
Term Survival ◽  
Refractory Heart Failure ◽  
Great Vessels

Background —Advances in surgical and medical management have greatly improved long-term survival rates in patients with congenital heart disease (CHD). As these patients reach adulthood, myocardial dysfunction can occur, leading to cardiac transplantation. Methods and Results —We reviewed the pretransplantation and posttransplantation courses of 24 patients >18 years old (mean age, 26 years; range, 18 to 56 years) with CHD who received a transplant between January 1985 and September 1998. The relation between preoperative and perioperative risk factors for complications and death was assessed. Single ventricle was the pretransplantation diagnosis for 12 patients (50%), and d -transposition of the great vessels was the diagnosis for 4 patients (16%). Twenty-two patients had a mean of 2 previous operations. At cardiac transplantation, additional surgical procedures were required to correct extracardiac lesions in 18 patients (75%). Refractory heart failure was present in 22 patients, significant cyanosis was present in 7, and protein-losing enteropathy was present in 4. There were 5 early deaths due to bleeding (n=3) and infection (n=2). The Kaplan-Meier survival rate after cardiac transplantation was 79% at 1 year and 60% at 5 years . No anatomic or surgical risk factor was predictive of death. The outcome of patients with CHD who received a transplant was compared with that for patients without CHD (n=788). Mean bypass and ischemic times were significantly longer in patients with CHD than in patients without CHD. Survival rates after transplantation did not differ significantly between patients with and those without CHD ( P =0.83). Conclusions —Successful cardiac transplantation is obtainable in adults with complex CHD, with an outcome similar to that of patients without CHD. A detailed assessment of cardiac anatomy and careful surgical planning are essential to the pretransplantation and posttransplantation management of these patients.

scholarly journals Surgery for Colorectal Cancer: A Trigger for Liver Metastases Development? New Insights into the Underlying Mechanisms

Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 177
Author(s):  
Simran Grewal ◽  
Steven J. Oosterling ◽  
Marjolein van Egmond
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Survival Rates ◽  
Metastatic Progression ◽  
Term Survival ◽  
Metastasis Development ◽  
Potential Trigger ◽  
Underlying Mechanisms

Surgery is a crucial intervention and provides the best chance of cure for patients with colorectal cancer. Experimental and clinical evidence, however, suggests that paradoxically surgery itself may precipitate or accelerate tumor recurrence and/or liver metastasis development. This review addresses the various aspects of surgery-induced metastasis formation and sheds light on the role of inflammation as potential trigger for metastasis development. Understanding these mechanisms may provide potential new perioperative interventions to improve treatment outcomes, and as such could transform the perioperative timeframe from a facilitator of metastatic progression to a window of opportunity to reduce the risk of liver metastasis development. Ultimately, this can potentially improve long-term survival rates and quality of life in patients with colorectal cancer.

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