Relationship of heart failure with occurrence and development of tumors / 肿瘤

ABSTRACT

Previous studies have shown that the patients with long-term cancer often have complications such as heart failure. However, the recent studies have shown a heightened risk of incident malignancy in the patients with preexisting heart failure as compared with the normal; there are significant differences even after excluding common pathogenic factors such as obesity. This phenomenon suggests that heart failure may be a carcinogenic condition. Some researchers believe that the systemic pathological processes, such as inflammation and oxidative stress, may promote both heart failure and cancer, leading to the occurrence of these two diseases intersecting. Another hypothesis is that the active neurohormonal system caused by heart failure can directly affect the occurrence, development and prognosis of tumors. When the heart failure occurs, the activities of sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) in the neurohormone system are greatly enhanced. The activation of SNS and RAAS is closely related to the tumor proliferation and angiogenesis, which may be an important way for heart failure to cause tumors. This paradigm is supported by both experimental researches and clinical investigations. On the one hand, tumor growth and metastatic spreading increase following the activation of SNS or RAAS invivo. On the other hand, the results of clinical observation have shown that the use of neurohormonal inhibitors, especially RAAS blockers, is associated with more favorable cancer outcomes. Exploring the relationship between heart failure and tumorigenesis, and then elucidating the key regulatory mechanisms of heart failure acting on tumors is now becoming a hot topic worldwide. This may provide a new basis for the clinical treatments of both heart failure and tumors.