Doxorubicin-induced Cardiomyopathy: Mechanisms, Diagnosis and Therapeutic Drugs

Abstract

Doxorubicin (DOX) is an anthracycline drug for cancer treatments, including breast cancer, prostate cancer, and some other types of malignancies. However, doxorubicin is toxic related does, exerting cardiotoxicity most severely on patients. Cardiotoxicity is defined as “toxicity that affects the heart” by the National Cancer Institute. Cardiomyopathy is a major side-effect. There are modern studies which showed there are direct relationship between the severity of DOX-induced cardiomyopathy and the amount of DOX that patients consumed. This review explains the mechanisms of DOX-induced cardiomyopathy, specifically the causes for the oxidative stress, mitochondria’s role in DOX-induced cardiomyopathy, and the relations with NOS ROS, and eNOS that ultimately cause the oxidative stress, which will be a crucial factor for the occurrence of DOX-induced cardiomyopathy. Besides, summarizing the diagnosis imaging modalities including echocardiogram, tissue doppler imaging, cardiac resonance imaging and multigated acquisition, and introduce the drugs that can alleviate cardiomyopathy, which are dexazoxane and liposomal DOX with their mechanisms and experiments results demonstrated.