Heart failure in cancer patients

Abstract

The purpose of the study was to conduct a systematic review of data on the role of heart failure (HF) in the development of cancer, as well as to discuss problems dealing with diagnosis and treatment of heart failure in cancer patients. Material and methods. A literature search was conducted using the Cochrane library, elibrary, medline, and embase databases over the past 7 years. The general mechanisms of heart failure and cancer, cardiotoxicity risk factors, and some aspects of the diagnosis and treatment of HF in cancer patients were analyzed. Results. The literature analysis indicates that cardiovascular disease and cancer have common risk factors. Several common pathophysiological mechanisms that associate HF with cancer have been identified. They include inflammation, oxidative stress, and neurohomonal activation. HF is known to be a common complication of aggressive cardiotoxic cancer therapy that can aggravate or trigger existing HF. Recent epidemiological studies have shown that the development of cancer is more common among patients with pre-existing HF. Although the reason for this relationship has not yet been identified, it is assumed that HF may be a pro-oncogenic condition. There are several strategies to prevent and treat toxicity of various chemotherapeutic drugs. They are all based on accurate patient selection, short- and longterm follow-up, and therapies that can prevent and delay cardiac dysfunction. Conclusion. The main goal of cardio-oncology is to prevent and treat of cardiotoxic effects of chemotherapy drugs. In this context, elucidation of the underlying mechanisms plays an important role in the development of strategies for the prevention of chemotherapy-associated cardiomyopathy. It is necessary to pay attention to the fact that there is more and more evidence that patients with HF have high risks of developing cancer, thereby requiring more attention. In general, understanding the direct and indirect mechanisms of the relationship between HF and cancer can help in the prevention and early diagnosis of these diseases.