ORIGINAL ARTICLE Atherogenic coefficient and atherogenic index in Doxorubicin–induced cardiotoxicity: impact of date palm extract Shimaa Mubarak 1 & Shadia Abdel Hamid 1 & Abdel Razik Farrag 2 & Nahla Samir 1 & Jihan Seid Hussein 3 Received: 9 May 2018 /Accepted: 5 June 2018 # Springer-Verlag London Ltd., part of Springer Nature 2018 Abstract Antitumor therapy usually destructs the physiological homeostasis and affects various organs during cancer treatment process. Doxorubicin (Dox) as a 40-year-old anthracycline antibiotic is a potent antineoplastic agent extensively used in the treatment of several malignancies. Nevertheless, its clinical application carries the risk of serious non-target tissues toxicities, in particular cardiomyopathy, which manifests as life-threatening congestive heart failure. Consequently, there is a much great interest to search for natural compounds with cardioprotective properties to decrease this cardiotoxic effect without decreasing its anticancer effect. In this context, the present study undertaken to investigate whether date palm fruit extract could offer protection against Dox-induced cardiomyopathy. Forty female albino rats used in this study and classified into four groups including control, date palm fruit extract, Dox, and treated groups. The results revealed that Dox administration showed changes in electrocardiography (ECG) pattern, increasing in troponin-I level and atherogenic indices with marked histopathological alterations. Meanwhile, pretreatment with date palm fruit extract attenuated myocardial toxicity induced by Dox. The current data have demonstrated that date palm fruit extract has cardioprotective effects against Dox-induced cardiotoxicity. These effects may be related to its high contents of flavonoids and its anti-atherogenic effects. Keywords Phoenix dactylifera L. . Cardioprotective . Doxorubicin . Cardiotoxicity . Atherogenic indices . ECG Introduction Cancer outcomes continue and develop owing to earlier rec- ognition and new-targeted treatments, with anthracycline che- motherapy that have an important role in the recent epoch of cancer treatment (Rimal et al. 2015; McGowan et al. 2017). Doxorubicin (Dox), also known as Adriamycin® or Rubex®, is a cytotoxic anthracycline antibiotic, which discov- ered from a mutated strain of Streptomyces peucetius (Mitry and Edwards 2016). Dox is an amphoteric, since it has both acidic and basic functions. These properties make Dox a versatile compound and allow it to enter various cellular compartments. Dox re- duced intracellularly to doxorubicinol that also has a biologi- cal activity (Octavia et al. 2012). The therapeutic utility of Dox and other anticancer anthracyclines is restricted due to a dose-dependent risk of cardiomyopathy and congestive heart failure that may occur during treatment or any time after completing chemotherapy (Menna and Salvatorelli 2017). Cardiomyopathy commonly defined as a heterogeneous group of myocardium diseases accompanied by mechanical and/or electrical dysfunction that usually display improper ventricular hypertrophy or dilatation and are due to multiple causes. It either be restricted to the heart or be involved in generalized systemic disorders, which may induce cardiovas- cular death or progressive heart failure. In other way, it may define as a group of diseases that affect heart muscles itself. It should be restricted to a condition primarily involving the myocardium (Garg and Singhal 2013). Although the mechanism underlying cardiotoxicity in- duced by Dox is not fully understood, several hypotheses have been suggested for the development of reactive oxygen spe- cies (ROS) in the pathogenesis of cardiotoxicity, this may be * Shimaa Mubarak Shimaamubarak2015@yahoo.com 1 Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt 2 Pathology Department, National Research Centre, Cairo, Egypt 3 Medical Biochemistry Department, National Research Centre, Cairo, Egypt Comparative Clinical Pathology https://doi.org/10.1007/s00580-018-2766-6