Oxidative stress and inflammation: determinants of anthracycline cardiotoxicity and possible therapeutic targets

Iacopo Fabiani, Alberto Aimo, Chrysanthos Grigoratos, Vincenzo Castiglione, Francesco Gentile, Luigi F. Saccaro, Chiara Arzilli, Daniela Cardinale, Claudio Passino, Michele Emdin

Research output: Contribution to journalReview articlepeer-review


Chemotherapy with anthracycline-based regimens remains a cornerstone of treatment of many solid and blood tumors but is associated with a significant risk of cardiotoxicity, which can manifest as asymptomatic left ventricular dysfunction or overt heart failure. These effects are typically dose-dependent and cumulative and may require appropriate screening strategies and cardioprotective therapies in order to minimize changes to anticancer regimens or even their discontinuation. Our current understanding of cardiac damage by anthracyclines includes a central role of oxidative stress and inflammation. The identification of these processes through circulating biomarkers or imaging techniques might then be helpful for early diagnosis and risk stratification. Furthermore, therapeutic strategies relieving oxidative stress and inflammation hold promise to prevent heart failure development or at least to mitigate cardiac damage, although further evidence is needed on their efficacy, either alone or as part of combination therapies with neurohormonal antagonists, which are the current adopted standard.

Original languageEnglish
Pages (from-to)881-890
Number of pages10
JournalHeart Failure Reviews
Issue number4
Publication statusPublished - Jul 2021


  • Anthracyclines
  • Cardiotoxicity
  • Inflammation
  • Oxidative stress

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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