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de Boer RA, Hulot JS, Tocchetti CG, et al. Common mechanistic pathways in cancer and heart failure. A scientific roadmap on behalf of the Translational Research Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur J Heart Fail. 2020;22(12):2272-2289doi: 10.1002/ejhf.2029.
de Boer, R. A., Hulot, J. S., Tocchetti, C. G., Aboumsallem, J. P., Ameri, P., Anker, S. D., Bauersachs, J., Bertero, E., Coats, A. J. S., Čelutkienė, J., Chioncel, O., Dodion, P., Eschenhagen, T., Farmakis, D., Bayes-Genis, A., Jäger, D., Jankowska, E. A., Kitsis, R. N., Konety, S. H., Larkin, J., Lehmann, L., Lenihan, D. J., Maack, C., Moslehi, J. J., Müller, O. J., Nowak-Sliwinska, P., Piepoli, M. F., Ponikowski, P., Pudil, R., Rainer, P. P., Ruschitzka, F., Sawyer, D., Seferovic, P. M., Suter, T., Thum, T., van der Meer, P., Van Laake, L. W., von Haehling, S., Heymans, S., Lyon, A. R., & Backs, J. (2020). Common mechanistic pathways in cancer and heart failure. A scientific roadmap on behalf of the Translational Research Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European journal of heart failure, 22(12), 2272-2289. https://doi.org/10.1002/ejhf.2029
de Boer, Rudolf A, et al. "Common mechanistic pathways in cancer and heart failure. A scientific roadmap on behalf of the Translational Research Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)." European journal of heart failure vol. 22,12 (2020): 2272-2289. doi: https://doi.org/10.1002/ejhf.2029
de Boer RA, Hulot JS, Tocchetti CG, Aboumsallem JP, Ameri P, Anker SD, Bauersachs J, Bertero E, Coats AJS, Čelutkienė J, Chioncel O, Dodion P, Eschenhagen T, Farmakis D, Bayes-Genis A, Jäger D, Jankowska EA, Kitsis RN, Konety SH, Larkin J, Lehmann L, Lenihan DJ, Maack C, Moslehi JJ, Müller OJ, Nowak-Sliwinska P, Piepoli MF, Ponikowski P, Pudil R, Rainer PP, Ruschitzka F, Sawyer D, Seferovic PM, Suter T, Thum T, van der Meer P, Van Laake LW, von Haehling S, Heymans S, Lyon AR, Backs J. Common mechanistic pathways in cancer and heart failure. A scientific roadmap on behalf of the Translational Research Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur J Heart Fail. 2020 Dec;22(12):2272-2289. doi: 10.1002/ejhf.2029. Epub 2020 Nov 12. PMID: 33094495; PMCID: PMC7894564.
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Eur J Heart Fail. 2020 Dec;22(12):2272-2289. doi: 10.1002/ejhf.2029. Epub 2020 Nov 12.

Common mechanistic pathways in cancer and heart failure. A scientific roadmap on behalf of the Translational Research Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

European journal of heart failure

Rudolf A de Boer, Jean-Sébastien Hulot, Carlo Gabriele Tocchetti, Joseph Pierre Aboumsallem, Pietro Ameri, Stefan D Anker, Johann Bauersachs, Edoardo Bertero, Andrew J S Coats, Jelena Čelutkienė, Ovidiu Chioncel, Pierre Dodion, Thomas Eschenhagen, Dimitrios Farmakis, Antoni Bayes-Genis, Dirk Jäger, Ewa A Jankowska, Richard N Kitsis, Suma H Konety, James Larkin, Lorenz Lehmann, Daniel J Lenihan, Christoph Maack, Javid J Moslehi, Oliver J Müller, Patrycja Nowak-Sliwinska, Massimo Francesco Piepoli, Piotr Ponikowski, Radek Pudil, Peter P Rainer, Frank Ruschitzka, Douglas Sawyer, Petar M Seferovic, Thomas Suter, Thomas Thum, Peter van der Meer, Linda W Van Laake, Stephan von Haehling, Stephane Heymans, Alexander R Lyon, Johannes Backs

Affiliations

  1. Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
  2. Université de Paris, PARCC, INSERM, Paris, France.
  3. CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.
  4. Department of Translational Medical Sciences and Interdepartmental Center of Clinical and Translational Research, Federico II University, Naples, Italy.
  5. Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genova, Genoa, Italy.
  6. Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
  7. Department of Cardiology & Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charité-Universitätsmedizin Berlin (Campus CVK), Berlin, Germany.
  8. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  9. Comprehensive Heart Failure Center, University Clinic Würzburg, Würzburg, Germany.
  10. San Raffaele Pisana Scientific Institute, Rome, Italy.
  11. Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
  12. Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', University of Medicine Carol Davila, Bucharest, Romania.
  13. Innate Pharma, Marseille, France.
  14. Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  15. Partner Site Hamburg/Kiel/Lübeck, DZHK (German Centre for Cardiovascular Research), Hamburg, Germany.
  16. University of Cyprus Medical School, Nicosia, Cyprus.
  17. Cardio-Oncology Clinic, Heart Failure Unit, Department of Cardiology, Athens University Hospital 'Attikon', National and Kapodistrian University of Athens Medical School, Athens, Greece.
  18. Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, CIBERCV, Badalona, Spain.
  19. Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
  20. CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain.
  21. Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.
  22. Department of Heart Diseases, Wroclaw Medical University, and Centre for Heart Diseases, University Hospital, Wroclaw, Poland.
  23. Departments of Medicine (Cardiology) and Cell Biology, Wilf Family Cardiovascular Research Institute, Albert Einstein Cancer Center, Albert Einstein College of Medicine, New York, NY, USA.
  24. Cardiovascular Division, Cardio-Oncology Program, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
  25. Royal Marsden NHS Foundation Trust, London, UK.
  26. Cardio-Oncology Unit, Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
  27. DZHK (German Centre for Cardiovascular Research), partner site, Heidelberg/Mannheim, Germany.
  28. DKFZ (German Cancer Research Center), Heidelberg, Germany.
  29. Cardio-Oncology Center of Excellence, Cardiovascular Division, Washington University in St. Louis, St. Louis, MO, USA.
  30. Division of Cardiovascular Medicine and Oncology, Cardio-Oncology Program, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  31. Department of Internal Medicine III, University of Kiel, Kiel, Germany.
  32. DZHK (German Centre for Cardiovascular Research), partner site, Hamburg/Kiel/Lübeck, Germany.
  33. School of Pharmaceutical Sciences, University of Geneva, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland.
  34. Translational Research Center in Oncohaematology, Geneva, Switzerland.
  35. Heart Failure Unit, Cardiology, G. da Saliceto Hospital, Piacenza, University of Parma, Parma, Italy.
  36. 1st Department Medicine-Cardioangiology, University Hospital and Medical Faculty, Hradec Kralove, Czech Republic.
  37. Medical University of Graz, University Heart Center - Division of Cardiology, Graz, Austria.
  38. Department of Cardiology, University Hospital Zurich, University Heart Center, Zurich, Switzerland.
  39. Center for Molecular Medicine, Maine Medical Center Research Institute, Maine Medical Center, Scarborough, ME, USA.
  40. University of Belgrade Faculty of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
  41. Swiss Cardiovascular Centre, Bern University, Bern, Switzerland.
  42. Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany.
  43. Division Heart and Lungs and Regenerative Medicine Centre, University Medical Centre Utrecht and Utrecht University, Utrecht, The Netherlands.
  44. Department of Cardiology and Pneumology, Heart Center, University of Göttingen Medical Center, Göttingen, Germany.
  45. German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany.
  46. Department of Cardiology, CARIM School for Cardiovascular Diseases Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
  47. Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium.
  48. Cardio-Oncology Service, Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College London, London, UK.
  49. Institute of Experimental Cardiology, Heidelberg University Hospital, Heidelberg, Germany.

PMID: 33094495 PMCID: PMC7894564 DOI: 10.1002/ejhf.2029

Abstract

The co-occurrence of cancer and heart failure (HF) represents a significant clinical drawback as each disease interferes with the treatment of the other. In addition to shared risk factors, a growing body of experimental and clinical evidence reveals numerous commonalities in the biology underlying both pathologies. Inflammation emerges as a common hallmark for both diseases as it contributes to the initiation and progression of both HF and cancer. Under stress, malignant and cardiac cells change their metabolic preferences to survive, which makes these metabolic derangements a great basis to develop intersection strategies and therapies to combat both diseases. Furthermore, genetic predisposition and clonal haematopoiesis are common drivers for both conditions and they hold great clinical relevance in the context of personalized medicine. Additionally, altered angiogenesis is a common hallmark for failing hearts and tumours and represents a promising substrate to target in both diseases. Cardiac cells and malignant cells interact with their surrounding environment called stroma. This interaction mediates the progression of the two pathologies and understanding the structure and function of each stromal component may pave the way for innovative therapeutic strategies and improved outcomes in patients. The interdisciplinary collaboration between cardiologists and oncologists is essential to establish unified guidelines. To this aim, pre-clinical models that mimic the human situation, where both pathologies coexist, are needed to understand all the aspects of the bidirectional relationship between cancer and HF. Finally, adequately powered clinical studies, including patients from all ages, and men and women, with proper adjudication of both cancer and cardiovascular endpoints, are essential to accurately study these two pathologies at the same time.

© 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Keywords: Angiogenesis; Cancer; Cardio-oncology; Cardiotoxicity; Clonal haematopoiesis; Extracellular matrix; Heart failure; Inflammation; Metabolism

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