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  • 80 -6 (92) 2026 - Odilov A.J., Khamroyev Kh.N. - SHIELDING THE MYOCARDIUM: METABOLIC INTERVENTIONS IN THE ERA OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY

80 -6 (92) 2026 - Odilov A.J., Khamroyev Kh.N. - SHIELDING THE MYOCARDIUM: METABOLIC INTERVENTIONS IN THE ERA OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY

SHIELDING THE MYOCARDIUM: METABOLIC INTERVENTIONS IN THE ERA OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY

Odilov A.J., Khamroyev Kh.N. - Asian International University

Resume

Anthracycline-based chemotherapy remains a cornerstone in the treatment of various hematologic and solid malignancies, but its clinical utility is fundamentally limited by dose-dependent, progressive, and often irreversible cardiotoxicity. This study reviews the molecular mechanisms of anthracycline-induced cardiotoxicity (AIC) and evaluates the therapeutic significance of metabolic shielding strategies. At the cellular level, anthracyclines induce a severe myocardial energy crisis by binding to Topoisomerase II beta, suppressing mitochondrial biogenesis, and forming iron-dependent complexes that generate massive reactive oxygen species (ROS). This dual assault paralyzes mitochondrial fatty acid β-oxidation — the heart's primary energy source. Traditional cardio-oncology strategies are primarily reactive, initiating neurohormonal blockade only after structural damage is detected via echocardiography. This paper highlights proactive metabolic interventions designed to preserve myocardial energy production without reducing antitumor efficacy. Key strategies include optimizing the L-carnitine shuttle system to restore fatty acid transport and reduce cell apoptosis, and utilizing dexrazoxane to target topoisomerase mechanisms and disrupt iron-mediated oxidative stress. The combined application of these metabolic shielding approaches improves the preservation of myocardial functional integrity and contributes to timely cardioprotective therapeutic decision-making and prevention of disease progression.

Keywords: Cardio-oncology, anthracycline cardiotoxicity, doxorubicin, mitochondrial dysfunction, L-carnitine shuttle, dexrazoxane, myocardial metabolism, reactive oxygen species (ROS).

First page

471

Last page

476

For citation:Odilov A.J., Khamroyev Kh.N. - SHIELDING THE MYOCARDIUM: METABOLIC INTERVENTIONS IN THE ERA OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY//New Day in Medicine 6(92)2026 471-476 https://newdayworldmedicine.com/en/new_day_medicine/6-92-2026

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