title: The emerging issue of cardiac dysfunction induced by antineoplastic angiogenesis inhibitors.
abstract: Left ventricular dysfunction from anticancer drugs has emerged as a relevant problem in the clinical and scientific communities. Anthracycline toxicity has always been the most relevant, but with the increasing use of biological targeted therapies in treatment protocols, with an increasing number of cancer survivors, new toxicities have been increasing in more recent years. Cardiomyopathy after ErbB2 inhibitors has been intensively studied. Another important class of biological anticancer drugs are vascular endothelial growth factor (VEGF) inhibitors. VEGF signalling is crucial for vascular growth, but it also has a major impact on myocardial function. Also, it is important to note that such angiogenesis inhibitors are multitargeted in most cases, and can produce a broad spectrum of cardiovascular side effects. Here we review the mechanisms and pathophysiology of the most significant cardiotoxic effects of antiangiogenic drugs, and particular attention is drawn to LV dysfunction, discussing the assessment and management on the basis of the most recent cardio-oncological findings and heart failure guidelines.
authors: Division of Cardiology, National Cancer Institute, Pascale Foundation, Naples, Italy. cgtocchetti@iol.it
authors: Carlo G
authors: CG
authors: Tocchetti
authors: Giuseppina
authors: G
authors: Gallucci
authors: Carmela
authors: C
authors: Coppola
authors: Giovanna
authors: G
authors: Piscopo
authors: Clemente
authors: C
authors: Cipresso
authors: Carlo
authors: C
authors: Maurea
authors: Aldo
authors: A
authors: Giudice
authors: Rosario V
authors: RV
authors: Iaffaioli
authors: Claudio
authors: C
authors: Arra
authors: Nicola
authors: N
authors: Maurea
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002319:Cardiovascular System / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D012307:Risk Factors; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D042461:Vascular Endothelial Growth Factor A