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Potential of Antioxidant and Cardioprotective Activity of a New Pyridoxine and Fumaric Acid Derivative as an Inductor of Transcription Factor Nrf2.

The aim of the study was to evaluate the biological activity of a new type of cardioprotectors, activators of Nrf2, based on pyridoxine and fumaric acid derivatives in vitro and in vivo. It was found that di(3-hydroxy-4,5-bis(hydroxymethyl)-2-methylpyridinium) fumarate is an effective activator of Nrf2 transcription factor and exhibits cytoprotective and antioxidant activity in vitro on a cardiomyocyte model. In addition, this compound reduces the cardiotoxic effect of doxorubicin in vivo by suppressing the development of oxidative processes and activating the Nrf2-dependent antioxidant respon

Diabetic Heart Disease: An Intricate Interplay of a Widespread Metabolic Disorder with the Cardiovascular System.

Diabetes is a chronic medical condition that causes high glycaemic levels, leading to damage to vital organs over time. It is a common disease worldwide, affecting around 422 million individuals living in middle- and low-income countries, which make up most of the population. Unfortunately, diabetes results in 1.5 million deaths annually. Diabetic patients are at a higher risk for developing cardiovascular conditions. Diabetic heart disease constitutes multiple genres, including diabetic cardiomyopathy, coronary artery disease, and heart failure. Hypoglycaemic agents aim to prevent these metab

Sodium-glucose cotransporter 2 inhibitors and the cancer patient: from diabetes to cardioprotection and beyond.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i), a new drug class initially designed and approved for treatment of diabetes mellitus, have been shown to exert pleiotropic metabolic and direct cardioprotective and nephroprotective effects that extend beyond their glucose-lowering action. These properties prompted their use in two frequently intertwined conditions, heart failure and chronic kidney disease. Their unique mechanism of action makes SGLT2i an attractive option also to lower the rate of cardiac events and improve overall survival of oncological patients with preexisting cardiovascu

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… Biological basis of SGLT2i protection against anthracycline-induced cardiotoxicity Anthracyclines represent the backbone treatment for several solid and hematological malignancies and are associated with potential dose-dependent cardiotoxic effects, eventually leading to the development of subclinical … Evidence regarding antimetabolites cardiotoxicity may reveal a cardioprotective role exerted by SGLT2i. …

Diosgenin: Mechanistic Insights on its Anti-inflammatory Effects.

Diosgenin (DG), a well-known steroid saponin, has shown anti-inflammatory effects. This review was aimed to discuss all published literature … shown that regulation of NF-κB and oxidative stress signaling pathways by DG is beneficial against cardiotoxicity induced by chemotherapeutic agents such as doxorubicin.

Current Opinion on Pixantrone in the Treatment of Non-Hodgkin B-Cell Lymphoma.

Not many treatment options exist for patients with relapsed or refractory (R/R) B-cell non-Hodgkin lymphoma (NHL) in whom first- and second- … iac dysfunction. This article summarizes the definition, structure, mechanism of action and reduced cardiotoxicity of pixantrone as well as efficacy and toxicity both in monotherapy and in combinations, as treatment for aggressive and indolent non-Hodgkin lymphomas.

Heart Failure and Diabetes Mellitus: Defining the Problem and Exploring the Interrelationship.

Type 2 diabetes mellitus and congestive heart failure are highly prevalent diseases with significant morbidity and mortality. These 2 diseases often occur concurrently because of shared risk factors such as coronary artery disease, and also because type 2 diabetes mellitus has direct cardiotoxic effects. Type 2 diabetes mellitus likely has a causative role in the development and prognosis of patients with heart failure. Optimal prevention and treatment of type 2 diabetes mellitus and heart failure likely involves identifying and treating their shared pathophysiologic features. Novel drug thera

Extracorporeal Membrane Oxygenation in Drug Overdose: A Clinical Case Series.

Overdose of cardiovascular medications such as beta blockers and calcium channel blockers cause impaired cardiac contractility, vasoplegia, and/or rhythm disturbances. In addition to conventional management of limiting absorption, increasing elimination and hemodynamic support intravenous (IV) calcium infusion, hyperinsulinemia-euglycemia therapy, glucagon infusion, and IV lipid emulsion have been tried. Extracorporeal circulatory assist device support has been reported as a rescue therapy in overdose refractory to maximal medical therapy. We report three patients with cardiovascular medicatio

Anthracyclines: a cornerstone in the management of non-Hodgkin's lymphoma.

Since anthracyclines were introduced in the treatment of non-Hodgkin's lymphoma in the late 1960s, they have been acknowledged as a cornerstone in the management of the disease and, in particular, of aggressive lymphomas. The high efficacy of anthracycline-containing regimens must, however, be balanced against the drug-related toxicity, which mainly affects the cardiovascular system and represents a major concern for clinicians, especially in the treatment of elderly patients. Patients' outcomes could be further improved, particularly for those at high risk of cardiotoxicity, by substituting l…

Amoxapine overdose in a young man: a transient mitochondrial abnormality?

Amoxapine is a second-generation tricyclic antidepressant structurally related to the neuroleptic loxapine. It was previously marketed as an alternative to traditional tricyclic antidepressants because of alleged shorter onset of action and fewer cardiotoxic effects. However, various adverse reactions, including cardiac dysrhythmias, renal failure, coma, seizures, and neuroleptic malignant syndrome, were reported during therapy or after acute overdose. A 14-year-old boy ingested 1900 mg of amoxapine and developed seizures, hypertension, hyperpyrexia, altered mental status, myoglobinuria, renal

Drug treatment of depression in medically ill patients.

Depressive symptoms are common in medically ill patients although depressive disorders are considerably underdiagnosed and undertreated. Dru … her drugs. Among the risks associated with specific medical conditions are orthostatic hypotension, cardiotoxicity, deterioration of seizure control in epileptic patients and increased side effects in patients with renal and hepatic impairment. The available data suggest that there is relatively little to choose between antidepressants in terms of efficacy (alth …

[Combination effects of CDDP, ACR and HCFU on progressive urothelial tumors].

Nine patients with progressive urothelial tumors treated with combination chemotherapy were evaluated. The median age of the patients was fi … ses of PR (28.5%), 4 cases of NC and one case of PD. No severe toxicities such as nephrotoxicity or cardiotoxicity, were revealed with this combination chemotherapy.

Relationship between potassium administration, hyperkalaemia and the electrocardiogram: an experimental study.

Hyperkalaemia affected the equine myocardium. The minimum plasma potassium concentration required to induce electrocardiographic changes was 6.2 mmol/litre and severe cardiotoxic effects were observed at levels of 8.0 to 10.1 mmol/litre in this experimental situation. The most consistent sign of hyperkalaemia was broadening and flattening of the P wave, which was generally associated with a change in T waves in the chest lead from negative to positive. The more pronounced the hyperkalaemia, the less pronounced the P wave and the more peaked positive the T wave. Severe hyperkalaemia was associa

Longitudinal echocardiographic systolic changes in dogs receiving doxorubicin-based chemotherapy.

BACKGROUND: Doxorubicin is widely used in veterinary oncology but carries a risk of cumulative cardiotoxicity. Serial echocardiographic evaluation is commonly used to monitor dogs receiving potentially cardiotoxic chemotherapy; however, evidence remains limited regarding which indices best capture early longitudinal systolic changes. Conventional monitoring relies largely on fractional shortening and M-mode estimated ejection fraction, which are based on geometric assumptions and may have limited sensitivity for subtle systolic change. This study evaluated whether Simpson-derived left ventricu…

Cardiomyopathies and a brief insight into DOX-induced cardiomyopathy.

BACKGROUND: Cardiomyopathy is a heterogeneous group of myocardial disorders characterized by structural and functional abnormalities of the … ous chemotherapy regimens, improving patient outcomes. However, their use is associated with severe cardiotoxicity, including cardiomyopathy and heart failure. The mechanisms of anthracycline action and toxicity are complex, involving DNA damage, iron-mediated free radical production, and disruption of cardiovascular homeostasis. Doxorubicin-induced cardiomyopat …

Late Cardiological Sequelae and Long-Term Monitoring in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi.

Cardiotoxicity represents the most frequent cause with higher morbidity and mortality among long-term sequelae affecting classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) patients. The multidisciplinary team of Fondazione Italiana Linfomi (FIL) researchers, with the methodological guide of Istituto di Ricerche Farmacologiche "Mario Negri", conducted a systematic review of the literature (PubMed, EMBASE, Cochrane database) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in order to analyze the following aspects of…

Decision-making challenges for implantable cardioverter-defibrillator therapy in breast cancer with ventricular tachycardia and undiagnosed leptomeningeal carcinomatosis.

Anthracycline-based chemotherapy is widely used in breast cancer but carries a risk of cardiotoxicity. Leptomeningeal carcinomatosis (LC) is a rare but fatal complication of metastatic breast cancer, often presenting with diverse neurological symptoms and requiring high clinical suspicion for diagnosis. We report a woman in her early 50s with HER2-positive breast cancer who received anthracycline-based chemotherapy. After treatment, she developed refractory ventricular tachycardia and underwent implantable cardioverter-defibrillator (ICD) implantation despite preserved cardiac function. Soon a…

Mercury-Mediated Cardiovascular Toxicity: Mechanisms and Remedies.

Mercury is a significant environmental pollutant and public health threat, primarily recognized for its neurotoxic effects. Increasing evide … flammation. This study offers a comprehensive analysis of the mechanisms underlying mercury-induced cardiotoxicity, focusing on oxidative stress, inflammation, and cellular dysfunction.

Immune Checkpoint Inhibitor Therapy and Acute Coronary Syndrome: A Review of Mechanisms and Management.

Immune checkpoint inhibitor (ICI) therapy is a class of immune-activating therapies that has revolutionized the treatment of various cancers over the past decade. With expanding clinical indications of this drug class, understanding the short-term and long-term implications of checkpoint inhibitor therapy has grown in importance. Numerous reports have highlighted potential inflammatory adverse effects, including cardiotoxicity. Efforts to characterize cardiovascular adverse events, however, have largely focused on myocarditis with emerging evidence demonstrating the association between ICI the…

Comprehensive analysis of Leonotis nepetifolia flower extracts: phytochemical composition and toxicity in zebrafish embryos.

Leonotis nepetifolia (L.) R. Br., a plant used in traditional medicine, has underexplored phytochemical and toxicological profiles. This study investigates the metabolite profile of L. nepetifolia flowers and assesses their toxicity using zebrafish (ZF) embryos. The main active compounds were characterised using metabolomic approaches. ZF embryos were exposed to methanol extract (CEF), n-hexane (FHF) and ethyl acetate (FAF) fractions at different concentrations for 96 h. Toxicological effects were assessed including acetylcholinesterase activity, lipid peroxidation, cardiotoxicity, as well as …

NAD in pathological cardiac remodeling: Metabolic regulation and beyond.

Nicotinamide adenine dinucleotide (NAD) coenzymes are carriers of high energy electrons in metabolism and also play critical roles in numero … ases, including pressure overload, myocardial infarction, cardiometabolic disease, cancer treatment cardiotoxicity, and heart failure. We next provide an update on the strategies and treatments to increase NAD levels, such as supplementation of NAD precursors, in the heart that prevent or reverse cardiomyopathy. We also introduce the approaches to manipulate NAD …