Cardiac Cachexia: Unaddressed Aspect in Cancer Patients

Cells. 2022 Mar 14;11(6):990. doi: 10.3390/cells11060990.

Abstract

Tumor-derived cachectic factors such as proinflammatory cytokines and neuromodulators not only affect skeletal muscle but also affect other organs, including the heart, in the form of cardiac muscle atrophy, fibrosis, and eventual cardiac dysfunction, resulting in poor quality of life and reduced survival. This article reviews the holistic approaches of existing diagnostic, pathophysiological, and multimodal therapeutic interventions targeting the molecular mechanisms that are responsible for cancer-induced cardiac cachexia. The major drivers of cardiac muscle wasting in cancer patients are autophagy activation by the cytokine-NFkB, TGF β-SMAD3, and angiotensin II-SOCE-STIM-Ca2+ pathways. A lack of diagnostic markers and standard treatment protocols hinder the early diagnosis of cardiac dysfunction and the initiation of preventive measures. However, some novel therapeutic strategies, including the use of Withaferin A, have shown promising results in experimental models, but Withaferin A's effectiveness in human remains to be verified. The combined efforts of cardiologists and oncologists would help to identify cost effective and feasible solutions to restore cardiac function and to increase the survival potential of cancer patients.

Keywords: angiotensin II; autophagy; cancer; cardiac cachexia; chemotherapy; proinflammatory cytokines; withaferin A.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Cachexia / etiology
  • Cachexia / metabolism
  • Cytokines
  • Heart Diseases* / metabolism
  • Humans
  • Muscular Atrophy / metabolism
  • Neoplasms* / complications
  • Neoplasms* / metabolism
  • Quality of Life

Substances

  • Cytokines