Abstract
Doxorubicin is a widely used antineoplastic agent that may cause irreversible dilated cardiomyopathy. Doxorubicin-induced cardiomyopathy (DIC) can occur several years after exposure and carries a poor prognosis. Although cardiac resynchronization therapy (CRT) is a useful intervention in end-stage heart failure unresponsive to optimal medical therapies, its efficacy in DIC remains unknown. Four consecutive patients receiving CRT for DIC were evaluated before and after CRT. CRT resulted in improvements in the mean left ventricular ejection fraction at 1 month from 21+/-4.7% to 34+/-5% (p=0.03) and at 6 months (to 46+/-7.5%, p=0.01). CRT-induced reverse remodeling was observed, with a mean reduction in left ventricular internal diameter at end-diastole from 54.75+/-3.7 to 52.5+/-1.9 mm at 1 month (p=0.06) and further to 47+/-2.3 mm at 6 months (p=0.03). All patients experienced reductions in heart failure symptoms and improvements in New York Heart Association functional class (p<0.05). The impact of CRT was sustained over a follow-up of 18.5+/-3.5 months. In conclusion, this study suggests that patients with DIC, refractory to optimal pharmacologic therapy and meeting criteria for resynchronization device implantation, may achie...Continue Reading
References
Sep 25, 1991·JAMA : the Journal of the American Medical Association·L J SteinherzM L Murphy
Sep 24, 1998·The New England Journal of Medicine·P K Singal, N Iliskovic
Apr 13, 2000·The New England Journal of Medicine·G M FelkerE K Kasper
Oct 5, 2002·Cancer·Gemma GattaFranco Berrino
Jun 1, 2004·Pharmacological Reviews·Giorgio MinottiLuca Gianni
Citations
May 24, 2012·Cardiovascular Toxicology·Sergey N KharinDmitry N Shmakov
Oct 3, 2012·PloS One·Yiu-fai CheungShau-yin Ha
Feb 16, 2010·The American Journal of Cardiology·John RickardBruce L Wilkoff
Mar 21, 2012·Fundamental & Clinical Pharmacology·Sergey KharinDmitry Shmakov
Apr 3, 2012·Journal of Molecular and Cellular Cardiology·Yanti OctaviaAn L Moens
Apr 26, 2016·Journal of Cardiac Failure·Roy B MukkuEric H Yang
May 16, 2017·Japanese Journal of Clinical Oncology·Kazuko TajiriIkuo Sekine
Aug 4, 2018·Heart Failure Reviews·Peggy M KostakouChristoforos D Olympios
Nov 22, 2014·Circulation. Heart Failure·Guilherme H OliveiraSoon J Park
Nov 13, 2019·JAMA : the Journal of the American Medical Association·Jagmeet P SinghUNKNOWN MADIT-CHIC Investigators
Mar 1, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Charlotte LeeMichael G Fradley
Feb 17, 2021·Pacing and Clinical Electrophysiology : PACE·Fatima M EzzeddineYong-Mei Cha
Jun 18, 2021·Circulation·Michael G FradleyBrian Olshansky
Sep 4, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Ragu KanagasabaiGovindasamy Ilangovan
Sep 8, 2021·Heart·Divyang PatelJohn Rickard