Cardiotoxicity of chemotherapy drugs and possible protective effects of physical exercise: a literature review

Resumo

This review was designed to summarize the main pathophysiological mechanisms of doxorubicin cardiotoxicity and the positive effects of physical exercise. Objective: To characterize a literature review on the main cardiotoxicity mechanisms already described and what possible strategies attenuate and/or prevent these side effects, with a focus on physical exercise. Methods: A literature search using PubMed (MEDLINE) and SciELO databases was conducted covering the articles published between 2000 and 2015. These studies were selected for posterior analysis, according to pre-established criteria. Results: Fifty-eight (58) articles based on references and according to the descriptors were found and 45 articles were included: 18 reviews, 19 articles developed with animal experiments, 07 articles with studies in humans and 01 guideline. Conclusion: Data analysis led us to understand that although there is no consensus about the doxorubicin mechanism of action that causes toxicity, the generation of reactive oxygen species and changes in intracellular calcium are the most studied mechanisms and provide the most evidence in literature. Other studies are still needed to elucidate the complex cardiotoxicity mechanisms and which strategies would be the best for cardioprotection. A possible therapeutic strategy that has been studied is implementing exercise, but some questions still arise, including: 1) What would be the best time to implement an exercise program, before or during chemotherapy? And 2) Could exercise play a cardioprotective role in preventing or attenuating toxic effects on the heart?

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Citação

COSTA, Thalyta Rocha et al. Cardiotoxicity of chemotherapy drugs and possible protective effects of physical exercise: a literature review. Journal of Respiratory and Cardiovascular Physical Therapy, Natal, v. 4, n. 2, p. 7-17, 2016. Disponível em: https://periodicos.ufrn.br/revistadefisioterapia/article/view/8909/8217. Acesso em: 6 fev. 2025.