Early Heart Changes May Offer Clues To Future Cancer Risk, Finds Study

Subtle changes in the heart's structure and function, detectable years before any symptoms appear, may help identify individuals at higher risk of developing certain cancers later in life, according to a new study led by researchers at UCLA Health.

The findings add to growing evidence that cardiovascular disease and cancer — the world's two leading causes of death — may be more closely connected than previously understood.

Published in the Journal of the American Heart Association, the study suggests that early alterations in the heart, known as cardiac remodelling, could serve as warning signals for future cancer risk, particularly breast and colorectal cancers.

According to researchers, the findings may eventually help doctors identify high-risk individuals earlier and strengthen preventive strategies aimed at both heart disease and cancer.

The study was led by Dr. Xinjiang Cai, cardiologist and physician-scientist at UCLA Health, who said the findings point towards shared biological pathways linking the two conditions.

"This study suggests that structural and functional changes in the heart may occur alongside — or even before — biological processes linked to cancer development," Dr. Cai said. "It adds to mounting evidence that these two diseases share underlying biological pathways and are intertwined."

To explore the relationship, researchers analysed data from the long-running Multi-Ethnic Study of Atherosclerosis (MESA), which enrolled more than 6,000 adults aged between 45 and 84 years who had no known cardiovascular disease at the time of recruitment between 2000 and 2002.

Participants underwent advanced cardiac magnetic resonance imaging (MRI) to assess the structure and function of their hearts. Researchers then tracked cancer diagnoses over an average follow-up period of 18 years.

The cohort included participants from diverse racial and ethnic backgrounds, including non-Hispanic White, Black, Hispanic/Latino and Chinese American populations, allowing investigators to examine long-term health outcomes across different groups.

During the follow-up period, researchers documented 790 new cancer cases, including breast, colorectal, lung and prostate cancers.

One of the most striking findings was that individuals showing early evidence of cardiac remodelling faced a higher likelihood of developing cancer years later.

Among the various measurements studied, increased left ventricular mass — a marker indicating thickening of the heart muscle — was strongly associated with a greater risk of breast cancer. Even after accounting for conventional cardiovascular and cancer risk factors, women with higher left ventricular mass indices showed a significantly elevated likelihood of developing breast cancer.

Researchers also identified a link between reduced function of the heart's left atrium and future colorectal cancer risk. Specifically, lower values of peak left atrial strain, which reflects the ability of the left atrium to expand and contract effectively, were associated with a higher incidence of colorectal cancer. Participants with healthier atrial function experienced substantially lower rates of the disease.

The study found a consistent trend: as indicators of cardiac remodelling worsened, cancer incidence increased.

While the findings are noteworthy, the researchers cautioned against interpreting them as evidence that heart changes directly cause cancer.

"These findings represent associations and do not establish causation," Dr. Cai explained. "The results do not mean higher left ventricular mass directly promotes breast cancer or better atrial function directly prevents colorectal cancer."

He noted that although the analysis adjusted for numerous known risk factors, unmeasured influences could still have affected the results. Detection bias and other limitations inherent to observational studies cannot be ruled out.

Previous studies by the same group and other investigators have shown that elevated cardiac biomarkers and coronary artery calcium scores are associated with future cancer development.

The new study advances this work by using sophisticated cardiac MRI technology capable of detecting subtle structural and functional heart changes before overt disease becomes apparent.

Researchers believe the findings may have important implications for preventive medicine.

Current cardiovascular guidelines already recommend aggressive management of risk factors such as high blood pressure, obesity, diabetes and metabolic disorders in individuals showing early signs of heart disease. The new evidence raises the possibility that such interventions could also influence future cancer risk.

"Early cardiac remodelling may serve as an early marker to identify individuals at risk for both cardiovascular disease and cancer," Dr. Cai said. "Our study suggests that imaging markers already used to identify people at risk for cardiovascular disease, including heart failure, may also help identify people at elevated risk for cancer."

The study involved collaboration among scientists from several leading institutions, including UCLA Health, the University of Washington, Johns Hopkins University and Kyoto University.