Potential Connections Among Cancer, Cancer Therapies, and the Genetic Predisposition for Cardiomyopathy and Cancer in PPCM Patients
DNA damage plays a central role in the development of cancer and also contributes to the development of heart failure. Mutations associated with cardiomyopathy render the heart more sensitive to stress induced by cardiotoxic treatment and pregnancy. Therefore, patients with mutations associated with DDR have a significantly elevated risk of developing cancer. Exposure to cardiotoxic cancer therapy, which either alone or in combination with mutations associated with DCM/HCM increases the risk for developing PPCM. Furthermore, heart failure may promote early onset cancer in CPS mutation carriers and thereby can explain, at least in part, the higher cancer risk in patients after PPCM. CPS = cancer predisposition syndrome; DCM = dilated cardiomyopathy; DDR = DNA damage response; HCM = hypertrophic cardiomyopathy; PPCM = peripartum cardiomyopathy.