The Role of Epithelial Mesenchymal Transition (EMT) in Pathogenesis of Cardiotoxicity: Diagnostic & Prognostic Approach.

Cancer is one of the diseases, which it is not still completely curable; the existing treatments are associated with many complications, that double its complexity. One of the causes of cancer cell metastasis is Epithelial Mesenchymal Transition (EMT). Recently study demonstrated that EMT cause cardiotoxicity and heart diseases such as heart failure, hypertrophy and fibrosis. This study evaluated molecular and signaling pathway, which lead to cardiotoxicity via EMT. It was demonstrated that the processes of inflammation, oxidative stress and angiogenesis were involved in EMT and cardiotoxicity. The pathways related to these processes act as a double-edged sword. In relation to inflammation and oxidative stress, molecular pathways caused apoptosis of cardiomyocytes and cardiotoxicity induction. While the angiogenesis process inhibits cardiotoxicity despite the progression of EMT. On the other hand, some molecular pathways such as PI3K/mTOR despite causing the progression of EMT lead to the proliferation of cardiomyocytes and prevent cardiotoxicity. Therefore, it was concluded that the identification of molecular pathways can help in designing therapeutic and preventive strategies to increase patients' survival.

Liver stiffness and liver function index in liver fibrosis patients afflicted with electrocardiographic abnormalities.

Introduction: Heart disorders are one of the causes of death in cirrhotic patients. Objectives: This study aimed to investigate liver stiffness and liver function indices in liver fibrosis patients afflicted with electrocardiographic abnormalities. Patients and Methods: wo hundred patients entered this cross-sectional study. First, all of the patients underwent liver elastography. They were then divided into four groups based on the results obtained. Patients in three of the total groups (I-III) had fibrosis and those in the fourth group (IV) had cirrhosis. Afterward, electrocardiograms were taken from the patients, and based on the existence of electrocardiographic abnormalities, the patients were divided into two groups (group 1, consisting of liver fibrosis patients with a heart disease and group 2, consisting of those without a heart disease). Finally, liver function index, liver stiffness, frequency of variables, and their relationship with the presence or absence of electrocardiographic (ECG) abnormalities were analyzed. Results: Forty-eight percent of the patients were afflicted with ECG abnormalities. The majority of the patients in each of the two groups were male. The differences between patients with and without electrocardiographic abnormalities as regards to liver stiffness, liver function index, and platelet count were found to be statistically significant (P < 0.05). However, the differences between the two groups with regard to serum transaminase levels did not appear to be statistically significant (P > 0.05). Conclusion: It seems that liver stiffness and liver function index are non-invasive factors for predicting the presence of accompanying heart disorders in patients suffering from liver fibrosis.