Key result
Recent advances in basic and molecular sciences have illuminated the mechanisms of anthracycline-associated and peripartum cardiomyopathies, showing potential for specific, disease-altering therapies.
Why the study?
Precise mechanisms and the ability to reliably predict who will develop cardiomyopathy and heart failure following anthracycline exposure or childbirth have remained elusive.
Mechanistic insights into anthracycline and peripartum cardiomyopathies reveal shared pathways of oxidative stress, apoptosis, and angiogenic imbalance, offering potential for targeted therapies.
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Risk stratification remains imprecise for anthracycline and peripartum cardiomyopathy; leaves open validated predictive models in prospective cohorts.
Anthracycline-associated cardiomyopathy and peripartum cardiomyopathy are nonischemic cardiomyopathies that often afflict previously healthy young patients; both diseases have been well described since at least the 1970s and both occur in the settings of predictable stressors (ie, cancer treatment and pregnancy). Despite this, the precise mechanisms and the ability to reliably predict who exactly will go on to develop cardiomyopathy and heart failure in the face of anthracycline exposure or childbirth have proven elusive. For both cardiomyopathies, recent advances in basic and molecular sciences have illuminated the complex balance between cardiomyocyte and endothelial homeostasis via 3 broad pathways: reactive oxidative stress, interference in apoptosis/growth/metabolism, and angiogenic imbalance. These advances have already shown potential for specific, disease-altering therapies, and as our mechanistic knowledge continues to evolve, further clinical successes are expected to follow.
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Cowgill et al. (2019) conducted a review in Anthracycline-associated cardiomyopathy and peripartum cardiomyopathy. Anthracycline exposure and childbirth was evaluated. Recent advances in basic and molecular sciences have illuminated the mechanisms of anthracycline-associated and peripartum cardiomyopathies, showing potential for specific, disease-altering therapies.
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