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Effects of Radiotherapy in Coronary Artery Disease.

PURPOSE OF REVIEW: This review describes the effects of radiotherapy (RT) on coronary artery disease, its mechanisms, and clinical and labor … n retrospective studies, systematic reviews, and meta-analyses. Clinical studies have shown that RT cardiotoxicity occurs decades after radiation, regardless of chemotherapy, and may occur earlier in patients with pre-existing risk factors or disease. The pathogenesis of radiation-induced coronary artery disease is complex and multifactorial, including endotheli …

Hypertension in the Cardio-Oncology Clinic.

As cancer therapies improve, the population of survivors of cancer has increased, and the long-term effects of cancer treatments have become more apparent. Cardiotoxicity is a well-established adverse effect of many antineoplastic agents. Hypertension is common in survivors of cancer, can be caused or worsened by certain agents, and has been shown to increase the risk of other cardiovascular diseases including heart failure. Pretreatment risk assessment and careful monitoring of blood pressure during therapy is essential. Aggressive management of preexisting or incident hypertension in survivo…

Multiple Episodes of Cardiac Arrest Induced by Treatment With Ibogaine: A Case Report.

Opioid dependence is a common problem, and therapeutic alternatives are scarce and ineffective. Ibogaine, illegal in several countries, has been reported as a possible therapy in alternative clinics and it is also used as a recreational drug, despite its cardiotoxic potential, including QT prolongation. We report a case of long QT leading to multiple episodes of cardiac arrest after a single dose of ibogaine (200mg, 2.6mg/Kg) in a patient without structural heart disease. This case highlights the fact that even low doses of ibogaine can be lethal and warns us about the consequences of its use.

Digoxin: Pharmacology and toxicology-A review.

Digoxin is a cardiac glycoside used as drug in case of heart problems, including congestive heart failure, atrial fibrillation or flutter, and certain cardiac arrhythmias. It has a very narrow therapeutic window of the medication. Digoxin is toxic substance with well known cardiotoxic effect. In this work, pharmacology and toxicology of digoxin are summarized; Its pharmacokinetics, pharmacodynamics, available acute toxicity data (different species, different administration routes) are summarized in this article. Moreover, its treatment side effect and human poisonings are thoroughly discussed.

[Systemic toxicity of local anaesthetics in children].

The article deals with an analysis of the publications devoted of local anaesthetics' systemic toxicity (LAST) due to regional anaesthesia and symptoms of this potentially lethal complication. The review discusses features of systemic absorption and forms of local anaesthetics' neurotoxicity and cardiotoxicity in children, including newborns, differences of clinical signs of the LAST in adults and children and dosage of racemic bupivacaine. Moreover, the article deals with a modified treatment protocol for LAST and a method of lipid resuscitation with 20% lipid emulsion in the form of Intralip…

Acute quetiapine overdose in an eleven-year-old girl.

We present a case of acute Quetiapine (SeroQuel) overdose in an 11-y-old girl who ingested 1,300 mg (22.2 mg/kg bw). Initial lethargy developed within I h followed by an episode of agitation and combativeness 3 h after ingestion. After treatment with lorazepam the patient experienced extended somnolence followed by return to normal mental status 16 h after ingestion. No cardiotoxic or laboratory abnormalities were found. This is the first report of acute Quetiapine overdose in an adolescent and suggests a relatively benign clinical course.

Mechanistic attenuation by L-carnitine of trastuzumab-induced downregulation of adenosine monophosphate -activated protein kinase signal in cardiac H9c2 cells.

BACKGROUND: Clinical usefulness of trastuzumab (TZ) is restrained owing to its cardiotoxic effect. This investigation was initiated to evalu … with the consequent decrease of ATP production and disturbs autophagy. Carnitine tempers TZ-related cardiotoxicity and acts as guard against TZ-related cardiac impact. The current findings are preliminary and highlight the need for additional studies to answer this current research question.

Beyond the Genomic Storm: Evaluating Tabernanthalog as a Potential Scaffold for Silent Neuroplasticity and Broad-Spectrum Therapy.

The clinical renaissance of psychedelic medicine has highlighted the therapeutic potential of rapid-acting neuroplastogens, or "psychoplastogens," for psychiatric disorders. However, the widespread application of classical psychedelics-such as psilocybin and LSD-and the atypical dissociative ibogaine is severely limited by their hallucinogenic properties and, particularly in the case of ibogaine, life-threatening cardiotoxicity. Addressing these limitations, Tabernanthalog (TBG) has emerged as a frontrunner in the field. This non-hallucinogenic analog of ibogaine was rationally designed to eli…

The impact of Centruroides tecomanus scorpion venom on cardiac function in rats during early envenomation.

Scorpion envenomation is a medical emergency that can produce severe cardiovascular complications. Centruroides tecomanus, an endemic scorpi … cantly. These findings characterize the early temporal progression of C. tecomanus venom-associated cardiotoxicity, beginning with rhythm and atrioventricular conduction abnormalities and accompanied by mild myocardial inter-fiber separation, but without overt necrosis or a conventional serum enzyme pattern of myocardial injury.

Impact of methamphetamine route of administration on cardiac function.

BackgroundMethamphetamine use is an increasingly detrimental public health crisis linked to significant cardiovascular harm, particularly me … nant individuals.Results/FindingsOur review of 57 papers showed that ROA may impact methamphetamine cardiotoxicity. Intravenous use is linked to abrupt hemodynamic stress, including rapid volume shifts, along with embolic risk and severe LVEF decline. Smoking leads to repeated dosing, oxidative stress, production of harmful pyrolytic intermediates and pulmonary …

Bibliometric analysis of research trends and collaboration patterns in cardio-oncology focusing on lung cancer and heart failure.

BACKGROUND: Lung cancer (LC) and heart failure (HF) are being increasingly seen as related conditions, with rising concerns about the cardio … lights an increasing focus on the link between LC and HF, particularly concerning treatment-induced cardiotoxicity. Nonetheless, studies on their two-way interaction are still scarce, pointing to a promising yet under-researched area. Combining oncology and cardiology could reveal new insights to tailor personalized care and enhance results. Our research provide …

Molecular Mechanisms of Effects of Lead and Cadmium Co-exposure on Atrial and Ventricular Myocardium: Soluble Salts Versus Nanoparticles.

Lead (Pb) and cadmium (Cd) are ubiquitous xenobiotics associated with cardiovascular diseases. While Pb and Cd cardiotoxicity is well studied, the molecular mechanisms of their co-exposure are poorly understood. We aimed to investigate the cardiotoxic effects of subchronic co-exposure to soluble versus nanoparticle forms of Pb and Cd on the atrial and ventricular myocardium. Rats received 18 intraperitoneal injections of combined Pb(C2H3O2)2 (6.01 mg/kg b.w.) and CdCl2 (0.377 mg/kg b.w.) solution over 6 weeks (Pb+Cd group). Another group received 18 injections of combined PbO (2.32 mg/kg b.w.)…

Reformulating rofecoxib: targeted nanostructured lipid carrier gel for localized treatment of rheumatoid arthritis.

OBJECTIVE: This study aimed to develop and evaluate nanostructured lipid carrier (NLC) gel loaded with rofecoxib (ROX) for topical treatment of rheumatoid arthritis (RA), minimizing systemic exposure and cardiotoxicity. SIGNIFICANCE: Despite its withdrawal due to cardiovascular risk, ROX remains a potent COX-2 inhibitor. Reformulating it into a localized NLC delivery system could enable safe therapeutic application in RA by targeting inflamed joints with minimal systemic effects. METHOD: A Box-Behnken design optimized lipid content, surfactant concentration, and sonication time to achieve mi…

Cardio-Oncology and Multi-Imaging Modalities.

Early detection and the rise of targeted cancer treatment have led to increased overall survival and decreased mortality among cancer patients. As the cancer survivor population ages, there is an increased risk for cardiovascular disease due to pre-existing comorbidities, deconditioning during therapy, or the natural progression of aging. Furthermore, with emerging oncologic therapies, there is an increased recognition of their potential cardiovascular toxicities. Indeed, heart disease is the leading cause of death in cancer survivors, which may reflect upon both the success of novel oncologic

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… Similar to the recommendations for anthracycline cardiotoxicity, patients on HER2-targeted monoclonal antibodies should undergo baseline ECHO and interval assessments during treatment. Unlike anthracycline cardiotoxicity, HER2 cardiotoxicity is not dose-dependent. … Select TKI such as osimertinib (EGFR-TKI) and ibrutinib (Bruton TKI) have associated cardiotoxic effects. …

O-phenylphenol induces cardiac injury by regulating cardiac progenitor cells in zebrafish (Danio rerio).

O-phenylphenol (OPP) is a widely used environmental contaminant, but its potential toxic effects on vertebrate cardiovascular development remain poorly understood. This study systematically evaluated OPP's developmental and cardiotoxic effects using zebrafish models, combining embryological exposure (0-9 mg/L, 5-72 h post-fertilization) with adult chronic exposure (0-4 mg/L, 30 days). Embryonic assessments combined morphological analysis, in situ hybridization, transcriptomics, and molecular pathway characterization, while adult chronic exposure studies focused on histological and functional c

Drug-induced torsadogenicity prediction model: An explainable machine learning-driven quantitative structure-toxicity relationship approach.

Drug-induced Torsade de Pointes (TdP), a life-threatening polymorphic ventricular tachyarrhythmia, emerges due to the cardiotoxic effects of pharmaceuticals. The need for precise mechanisms and clinical biomarkers to detect this adverse effect presents substantial challenges in drug safety assessment. In this study, we propose that analyzing the physicochemical properties of pharmaceuticals can provide valuable insights into their potential for torsadogenic cardiotoxicity. Our research centers on estimating TdP risk based on the molecular structure of drugs. We introduce a novel quantitative s…

Doxorubicin Dose-Dependent Impact on Physiological Balance-A Holistic Approach in a Rat Model.

Doxorubicin (DOX) is commonly used in several chemotherapies to treat various cancers, but it is known to cause cardiotoxicity and cardiac symptoms. Autonomic dysfunction is thought to contribute to the cardiotoxic effects of DOX, but the specific dose required to disrupt homeostatic processes is still unclear and is influenced by numerous factors. This study aimed to investigate how the DOX dosage affects autonomic function and physiological parameters, to elucidate the neurocardiac mechanisms underlying the observed cardiovascular side effects. Wistar rats were treated with DOX for four week…

Juvenile exposure to doxorubicin alters the cardiovascular response to adult-onset psychosocial stress in mice.

Childhood cancer survivors have a high risk for premature cardiovascular diseases, mainly due to cardiotoxic cancer treatments such as doxor … o CSS. In conclusion, we established a translationally relevant mouse model of juvenile DOX-induced cardiotoxicity that predisposes to adult-onset stress-induced adverse cardiac remodeling. Psychosocial stress should be taken into consideration in cardiovascular risk stratification of DOX-treated childhood cancer survivors.

Comprehensive Cardiac Safety Assessment using hiPS-cardiomyocytes (Consortium for Safety Assessment using Human iPS Cells: CSAHi).

Current cardiac safety assessment platforms (in vitro hERG-centric, APD, and/or in vivo animal QT assays) are not fully predictive of drug-induced Torsades de Pointes (TdP) and do not address other mechanism-based arrhythmia, including ventricular tachycardia or ventricular fibrillation, or cardiac safety liabilities such as contractile and structural cardiotoxicity which are another growing safety concerns. We organized the Consortium for Safety Assessment using Human iPS cells (CSAHi; http://csahi.org/en/) in 2013, based on the Japan Pharmaceutical Manufacturers Association (JPMA), to verify…

How progressive cancer endangers the heart: an intriguing and underestimated problem.

Since it came into being as a discipline, cardio-oncology has focused on the prevention and treatment of cardiotoxicity induced by antitumor chemotherapy and radiotherapy. Over time, it has been proved that even more detrimental is the direct effect generated by cancer cells that release pro-cachectic factors in the bloodstream. Secreted molecules target different organs at a distance, including the heart. Inflammatory and neuronal modulators released by the tumor bulk, either as free molecules or through exosomes, contribute to the pathogenesis of cardiac disease. Progressive cancer causes ca…