An important priority in the cardiovascular care of oncology patients is to reduce morbidity and mortality, and improve the quality of life in cancer survivors through cross-disciplinary efforts. The rate of survival in cancer patients has improved dramatically over the past decades. Nonetheless, survivors may be more likely to die from cardiovascular disease in the long term, secondary, not only to the potential toxicity of cancer therapeutics, but also to the biology of cancer. In this context, efforts from basic and translational studies are crucial to understanding the molecular mechanisms causal to cardiovascular disease in cancer patients and survivors, and identifying new therapeutic targets that may prevent and treat both diseases. This review aims to highlight our current understanding of the metabolic interaction between cancer and the heart, including potential therapeutic targets. An overview of imaging techniques that can support both research studies and clinical management is also provided. Finally, this review highlights opportunities and challenges that are necessary to advance our understanding of metabolism in the context of cardio-oncology.
Keywords: 99mTc-MIBI, 99mtechnetium-sestamibi; CVD, cardiovascular disease; D2-HG, D-2-hydroxyglutarate; FAO, fatty acid oxidation; FASN, fatty acid synthase; GLS, glutaminase; HF, heart failure; IDH, isocitrate dehydrogenase; IGF, insulin-like growth factor; MCT1, monocarboxylate transporter 1; MRS, magnetic resonance spectroscopy; PDH, pyruvate dehydrogenase; PET, positron emission tomography; PI3K, insulin-activated phosphoinositide-3-kinase; PTM, post-translational modification; SGLT2, sodium glucose co-transporter 2; TRF, time-restricted feeding; [18F]FDG, 2-deoxy-2-[fluorine-18]fluoro-D-glucose; cancer; cardio-oncology; heart failure; metabolism; oncometabolism; α-KG, α-ketoglutarate.
© 2021 Published by Elsevier on behalf of the American College of Cardiology Foundation.