Shared and Reciprocal Mechanisms Between Heart Failure and Cancer　― An Emerging Concept of Heart-Cancer Axis

Epidemiological evidence of increased risks of cancer in heart failure (HF) patients and HF in cancer patients has suggested close relationships between the pathogenesis of both diseases. Indeed, HF and cancer share common risk factors, including aging and unhealthy lifestyles, and underlying mechan...

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Bibliographic Details
Published in:Circulation Journal 2024/01/25, Vol.88(2), pp.182-188
Main Authors: Kadowaki, Hiroshi, Akazawa, Hiroshi, Shindo, Akito, Ueda, Tomomi, Ishida, Junichi, Komuro, Issei
Format: Article
Language:English
Subjects:
Cachexia
Chronic inflammation
Clonal hematopoiesis of indeterminate potential
Renin-angiotensin-aldosterone system
Sympathetic nervous system
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Summary:Epidemiological evidence of increased risks of cancer in heart failure (HF) patients and HF in cancer patients has suggested close relationships between the pathogenesis of both diseases. Indeed, HF and cancer share common risk factors, including aging and unhealthy lifestyles, and underlying mechanisms, including activation of the sympathetic nervous system and renin-angiotensin-aldosterone system, chronic inflammation, and clonal hematopoiesis of indeterminate potential. Mechanistically, HF accelerates cancer development and progression via secreted factors, so-called cardiokines, and epigenetic remodeling of bone marrow cells into an immunosuppressive phenotype. Reciprocally, cancer promotes HF via cachexia-related wasting and metabolic remodeling in the heart, and possibly via cancer-derived extracellular vesicles influencing myocardial structure and function. The novel concept of the “heart-cancer axis” will help in our understanding of the shared and reciprocal relationships between HF and cancer, and provide innovative diagnostic and therapeutic approaches for both diseases.
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-23-0838