In the Western countries cardiovascular disease and cancer are the leading causes
of death in the ageing population. Recent epidemiological data suggest that cancer
is more frequent in patients with prevalent or incident cardiovascular disease, in
particular heart failure. Indeed, there is a tight link in terms of shared risk factors
and mechanisms between heart failure and cancer. Heart failure induced by anticancer
therapies has been extensively studied, primarily focusing on the toxic effects that
antitumor treatments exert on cardiomyocytes. In this Cardio-Oncology update, members
of the ESC WGs of Myocardial Function and of Cellular Biology of the Heart discuss
novel evidence interconnecting cardiac dysfunction and cancer via pathways in which
cardiomyocytes may be involved, but are not central. In particular, the multiple roles
of cardiac stromal cells (endothelial cells, fibroblasts) and inflammatory cells are
highlighted. Also, the gut microbiota is depicted as a new player at the crossroads
between heart failure and cancer. Finally, the role of non-coding RNAs in Cardio-Oncology
is also addressed. All these insights are expected to fuel additional research efforts
in the field of Cardio-Oncology.
