VARIOUS REASONS FOR CARDIOTOXICITY: AN UPDATED REVIEW
DOI:
https://doi.org/10.22159/ijcpr.2025v17i5.7022Keywords:
Cardiotoxicity, Anthracyclines, Drug-induced cardiotoxicity, Pharmacogenomics, Heart diseases, PreventionAbstract
Injury to the heart muscle caused by exposure to toxins is called cardiotoxicity and it weakens cardiac function. Cardiotoxicity is one of the most severe adverse effects of cancer treatment and significantly adds to morbidity and mortality. Ventricular systolic dysfunction-induced heart failure is the most frequent and lethal side effect of chemotherapy drugs on the cardiovascular system. Arrhythmias, myocardial ischemia, pericardial disease, hypertension, and thromboembolic disease are additional deleterious consequences. It is a critical problem in environmental health, cancer, and clinical pharmacology. Drug-induced cardiotoxicity (DICT) is a serious problem with drug safety in both clinical use and drug development. The primary reasons for cardiotoxicity are discussed in this research with a focus on drug-induced mechanisms, environmental exposures, genetic susceptibility, and clinical conditions posing threats to cardiac well-being.
Downloads
References
1. Osanlou O, Pirmohamed M, Daly AK. Pharmacogenetics of adverse drug reactions. Adv Pharmacol. 2018 Jan 1;83:155-90. doi: 10.1016/bs.apha.2018.03.002, PMID 29801574.
2. Pereira NL, Weinshilboum RM. Cardiovascular pharmacogenomics and individualized drug therapy. Nat Rev Cardiol. 2009 Oct;6(10):632-8. doi: 10.1038/nrcardio.2009.154, PMID 19707183.
3. Herrmann J, Lenihan D, Armenian S, Barac A, Blaes A, Cardinale D. Defining cardiovascular toxicities of cancer therapies: an international cardio-oncology society (IC-OS) consensus statement. Eur Heart J. 2022 Jan 21;43(4):280-99. doi: 10.1093/eurheartj/ehab674, PMID 34904661.
4. Carroll CL, Coro M, Cowl A, Sala KA, Schramm CM. Transient occult cardiotoxicity in children receiving continuous beta-agonist therapy. World J Pediatr. 2014 Nov;10(4):324-9. doi: 10.1007/s12519-014-0467-z, PMID 24599614.
5. Yu Z, Liu J, Van Veldhoven JP, IJzerman AP, Schalij MJ, Pijnappels DA. Allosteric modulation of Kv11.1 (hERG) channels protects against drug induced ventricular arrhythmias. Circ Arrhythm Electrophysiol. 2016 Apr;9(4):e003439. doi: 10.1161/CIRCEP.115.003439, PMID 27071825.
6. Beach SR, Celano CM, Noseworthy PA, Januzzi JL, Huffman JC. QTc prolongation torsades de pointes and psychotropic medications. Psychosomatics. 2013 Jan 1;54(1):1-13. doi: 10.1016/j.psym.2012.11.001, PMID 23295003.
7. Cubeddu LX. Drug induced inhibition and trafficking disruption of ion channels: pathogenesis of QT abnormalities and drug induced fatal arrhythmias. Curr Cardiol Rev. 2016 May 1;12(2):141-54. doi: 10.2174/1573403x12666160301120217, PMID 26926294.
8. Castrillon JA, Eng C, Cheng F. Pharmacogenomics for immunotherapy and immune related cardiotoxicity. Hum Mol Genet. 2020 Oct 1;29(R2):R186-96. doi: 10.1093/hmg/ddaa137, PMID 32620943.
9. Lewis CM, Weber RS. Performance improvement in head and neck cancer. Curr Oncol Rep. 2018;20(1):1. doi: 10.1007/s11912-018-0655-4, PMID 29349566.
10. Mladenka P, Applova L, Patocka J, Costa VM, Remiao F, Pourova J. Comprehensive review of cardiovascular toxicity of drugs and related agents. Med Res Rev. 2018 Jul;38(4):1332-403. doi: 10.1002/med.21476, PMID 29315692.
11. Franco VI, Lipshultz SE. Cardiac complications in childhood cancer survivors treated with anthracyclines. Cardiol Young. 2015 Aug;25Suppl 2:107-16. doi: 10.1017/S1047951115000906, PMID 26377717.
12. Raschi E, Vasina V, Ursino MG, Boriani G, Martoni A, De Ponti F. Anticancer drugs and cardiotoxicity: insights and perspectives in the era of targeted therapy. Pharmacol Ther. 2010 Feb 1;125(2):196-218. doi: 10.1016/j.pharmthera.2009.10.002, PMID 19874849.
13. Orsolini L, De Berardis D, Volpe U. Up-to-date expert opinion on the safety of recently developed antipsychotics. Expert Opin Drug Saf. 2020 Aug 2;19(8):981-98. doi: 10.1080/14740338.2020.1795126, PMID 32657173.
14. Kim JJ, Kim YS, Kumar V. Heavy metal toxicity: an update of chelating therapeutic strategies. J Trace Elem Med Biol. 2019 Jul 1;54:226-31. doi: 10.1016/j.jtemb.2019.05.003, PMID 31109617.
15. Mathews VV, Paul MV, Abhilash M, Manju A, Abhilash S, Nair RH. Myocardial toxicity of acute promyelocytic leukaemia drug-arsenic trioxide. Eur Rev Med Pharmacol Sci. 2013 Feb 1;17Suppl 1:34-8. PMID 23436664.
16. Manna P, Sinha M, Sil PC. Arsenic induced oxidative myocardial injury: protective role of arjunolic acid. Arch Toxicol. 2008 Mar;82(3):137-49. doi: 10.1007/s00204-007-0272-8, PMID 18197399.
17. Mostafalou S. Concerns of environmental persistence of pesticides and human chronic diseases. Clinic Experiment Pharmacol. 2012;1(S5):2. doi: 10.4172/2161-1459.S5-e002.
18. D Oria R, Schipani R, Leonardini A, Natalicchio A, Perrini S, Cignarelli A. The role of oxidative stress in cardiac disease: from physiological response to injury factor. Oxid Med Cell Longev. 2020;2020(1):5732956. doi: 10.1155/2020/5732956, PMID 32509147.
19. Sharifi Rad M, Anil Kumar NV, Zucca P, Varoni EM, Dini L, Panzarini E. Lifestyle oxidative stress and antioxidants: back and forth in the pathophysiology of chronic diseases. Front Physiol. 2020 Jul 2;11:694. doi: 10.3389/fphys.2020.00694, PMID 32714204.
20. Zhang Z, Huang Q, Zhao D, Lian F, Li X, Qi W. The impact of oxidative stress-induced mitochondrial dysfunction on diabetic microvascular complications. Front Endocrinol. 2023 Feb 7;14:1112363. doi: 10.3389/fendo.2023.1112363, PMID 36824356.
21. Ping Z, Peng Y, Lang H, Xinyong C, Zhiyi Z, Xiaocheng W. Oxidative stress in radiation induced cardiotoxicity. Oxid Med Cell Longev. 2020;2020(1):3579143. doi: 10.1155/2020/3579143, PMID 32190171.
22. Attina G, Triarico S, Romano A, Maurizi P, Mastrangelo S, Ruggiero A. Serum biomarkers for the detection of cardiac dysfunction in childhood cancers receiving anthracycline based treatment. Biomed Pharmacol J. 2022 Sep 29;15(3):1311-21. doi: 10.13005/bpj/2468.
23. Al Hasnawi Z, Hasan HM, Abdul Azeez JM, Kadhim N, Shimal AA, Sadeq MH. Cardioprotective strategies in the management of chemotherapy induced cardiotoxicity: current approaches and future directions. Ann Med Surg (Lond). 2024 Dec 1;86(12):7212-20. doi: 10.1097/MS9.0000000000002668, PMID 39649884.
Published
How to Cite
Issue
Section
Copyright (c) 2025 KANAV KALRA, AJEET PAL SINGH, AMAR PAL SINGH

This work is licensed under a Creative Commons Attribution 4.0 International License.