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A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo
Published on: May 16, 2020
Decitabine induced transient cardiomyopathy: a case report.
Chitradeep De1, Jaya Phookan, Valay Parikh
1Department of Cardiology, Staten Island University Hospital, New York.
Clinical Medicine Insights. Oncology
|October 17, 2012
Summary
Decitabine chemotherapy can cause reversible cardiomyopathy, presenting as chest pain and elevated cardiac enzymes. Prompt diagnosis and drug discontinuation led to full recovery in this Acute Myeloid Leukemia patient.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Decitabine is a hypomethylating agent used in cancer therapy, primarily for Myelodysplastic Syndromes (MDS).
- While generally well-tolerated, chemotherapy agents can have various adverse effects, including potential cardiotoxicity.
- Acute Myeloid Leukemia (AML) patients often have comorbidities and receive intensive treatments, increasing risk for complex medical events.
Observation:
- A 75-year-old male with AML and diabetes presented with exertional dyspnea and chest pain one week after decitabine chemotherapy.
- Elevated cardiac enzymes (troponin, CKMB), elevated BNP, and reduced ejection fraction (35%) indicated acute cardiac injury and cardiogenic shock.
- Left heart catheterization revealed non-obstructive coronary artery disease, ruling out acute myocardial infarction as the primary cause.
Findings:
- The patient was diagnosed with reversible, non-ischemic cardiomyopathy, likely secondary to decitabine-induced cardiotoxicity.
- Cardiac function and troponin levels returned to baseline after discontinuation of decitabine chemotherapy.
- Negative infectious workup (blood/urine cultures, viral serology) supported a non-infectious etiology for the cardiomyopathy.
Implications:
- This case highlights acute myocarditis as a rare but potential adverse effect of decitabine chemotherapy.
- Cardiovascular monitoring and evaluation are crucial in patients receiving decitabine, especially those with pre-existing cardiac risk factors.
- Prompt recognition and management, including drug cessation, can lead to favorable outcomes and resolution of chemotherapy-induced cardiomyopathy.
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