title: Anthracycline-mediated cardiomyopathy: basic molecular knowledge for the cardiologist.
abstract: Anthracyclines are cytostatic antibiotics discovered almost half a century ago exerting their action through inhibition of topoisomerase II. The two most representative drugs are doxorubicin and daunorubicin and they have been proven as useful antineoplastics and are widely prescribed in daily oncology practice; unfortunately, cardiotoxicity has been a limiting factor when it comes to their use. Diverse mechanisms have been involved in anthracycline cardiotoxicity, none of which are capable of causing the whole clinical picture by itself. Traditionally, reactive oxygen species (ROS) have received more attention, although recently basic research has proven other factors to be as important as ROS. These factors mainly involve sarcomeric structure disruption, toxic accumulation of metabolites, iron metabolism, energetic alterations and inflammation. The role of genetics has been studied by some groups, although a clear genotype-response relationship is yet to be elucidated. With the improved survival from different oncologic diseases we are witnessing more cases of chemotherapy-induced cardiotoxicity and the advent of new anticancer drugs poses several challenges for the cardiologist, highlighting the importance of a deep knowledge of the main mechanisms inducing this toxicity.
authors.affiliation: Unidad de Miocardiopatías, Insuficiencia Cardíaca y Trasplante, Área de Enfermedades del Corazón, Hospital Universitari de Bellvitge, Barcelona, Spain. Electronic address: jsalazar@bellvitgehospital.cat.
authors.forename: Joel
authors.initials: J
authors.lastname: Salazar-Mendiguchía
authors.affiliation: Unidad de Miocardiopatías, Insuficiencia Cardíaca y Trasplante, Área de Enfermedades del Corazón, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: González-Costello
authors.affiliation: Unidad de Miocardiopatías, Insuficiencia Cardíaca y Trasplante, Área de Enfermedades del Corazón, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Roca
authors.affiliation: Unidad de Miocardiopatías, Insuficiencia Cardíaca y Trasplante, Área de Enfermedades del Corazón, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Ariza-Solé
authors.affiliation: Unidad de Miocardiopatías, Insuficiencia Cardíaca y Trasplante, Área de Enfermedades del Corazón, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Manito
authors.affiliation: Unidad de Miocardiopatías, Insuficiencia Cardíaca y Trasplante, Área de Enfermedades del Corazón, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Cequier
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects* / Q000378:metabolism; D002309:Cardiology; D009202:Cardiomyopathies / Q000139:chemically induced*; D006801:Humans
chemical_list: D018943:Anthracyclines
keywords: Anthracycline cardiotoxicity; Cardiotoxicidad de antraciclinas; Chemotherapy cardiomyopathy; Doxorubicin cardiomyopathy; España; Miocardiopatía por doxorrubicina; Miocardiopatía por quimioterapia; Spain