{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:25:01Z","timestamp":1791465901401,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We present the hypothesis that advanced stage cancer is also a heart failure syndrome. It can develop independently of or in addition to cardiotoxic effects of anti\u2010cancer therapies. This includes an increased risk of ventricular arrhythmias. We suggest the pathophysiologic link for these developments includes generalized muscle wasting (i.e. sarcopenia) due to tissue homeostasis changes leading to cardiac wasting associated cardiomyopathy. Cardiac wasting with thinning of the ventricular wall increases ventricular wall stress, even in the absence of ventricular dilatation. In addition, arrhythmias may be facilitated by cellular wasting processes affecting structure and function of electrical cells and conduction pathways.<\/jats:p>\n                  <jats:p>We submit that in some patients with advanced cancer (but not terminal cancer), heart failure therapy or defibrillators may be relevant treatment options. The key points in selecting patients for such therapies may be the predicted life expectancy, quality of life at intervention time, symptomatic burden, and consequences for further anti\u2010cancer therapies.<\/jats:p>\n                  <jats:p>The cause of death in advanced cancer is difficult to ascertain and consensus on event definitions in cancer is not established yet. Clinical investigations on this are called for. Broader ethical considerations must be taken into account when aiming to target cardiovascular problems in cancer patients.<\/jats:p>\n                  <jats:p>We suggest that focused attention to evaluating cardiac wasting and arrhythmias in cancer will herald a further evolution in the rapidly expanding field of cardio\u2010oncology.<\/jats:p>","DOI":"10.1002\/jcsm.12694","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T06:56:06Z","timestamp":1616050566000},"page":"533-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Advanced cancer is also a heart failure syndrome: a hypothesis"],"prefix":"10.1002","volume":"12","author":[{"given":"Markus S.","family":"Anker","sequence":"first","affiliation":[{"name":"Department of Cardiology &amp; Berlin Institute of Health Center for Regenerative Therapies (BCRT) German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin (Campus CVK)  Berlin Germany"},{"name":"Department of Cardiology Charit\u00e9 Universit\u00e4tsmedizin Berlin (Campus CBF)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Pardo","family":"Sanz","sequence":"additional","affiliation":[{"name":"University Hospital Ram\u00f3n y Cajal  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L.","family":"Zamorano","sequence":"additional","affiliation":[{"name":"University Hospital Ram\u00f3n y Cajal  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep R.","family":"Mehra","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Mississippi Medical Center  Jackson MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanno","family":"Riess","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology and Tumor Immunology (Campus CCM) Charite, University Medicine  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Pisana  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology &amp; Berlin Institute of Health Center for Regenerative Therapies (BCRT) German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin (Campus CVK)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw211"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1168"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1376"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1385"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12493"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197402)33:2<568::AID-CNCR2820330236>3.0.CO;2-2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1689"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.12.979"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw604"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1252"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005200050281"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12551"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12386"},{"key":"e_1_2_9_15_1","unstructured":"HowladerN NooneAM KrapchoM MillerD BrestA YuM et al. 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