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Myocarditis III: Medical Management01:14

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Cardiomyopathy V: Interprofessional Care01:29

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Heart Failure Drugs: Inotropic Agents01:26

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Updated: Sep 9, 2025

A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo
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Cardiotoxicidad por trastuzumab: mecanismo y tratamiento

Minoru Wakasa1, Miharu Masaki1, Kouji Kajinami1

  • 1Department of Cardiology, Kanazawa Medical University.

Biological & pharmaceutical bulletin
|August 31, 2025
PubMed
Resumen
Este resumen es generado por máquina.

El trastuzumab es un medicamento vital para el cáncer de mama, pero puede causar problemas cardíacos. Comprender sus riesgos cardíacos, el diagnóstico y los tratamientos es crucial para la seguridad del paciente.

Palabras clave:
Cardiotoxicidadreceptor del factor de crecimiento epidérmico humano tipo 2El trastuzumab

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Área de la Ciencia:

  • En el campo de la oncología
  • Cardiología
  • Farmacología

Sus antecedentes:

  • El trastuzumab es un tratamiento ampliamente utilizado para el cáncer de mama.
  • Contiene un riesgo de cardiotoxicidad, incluyendo arritmia, miocardiopatía y insuficiencia cardíaca.
  • Se están aclarando los mecanismos de cardiotoxicidad inducida por trastuzumab, potencialmente involucrando al receptor B2 del oncogén eritroblástico.

Objetivo del estudio:

  • Revisar los mecanismos, los enfoques de diagnóstico y las estrategias terapéuticas/preventivas para la cardiotoxicidad asociada con las terapias contra el receptor 2 del factor de crecimiento epidérmico humano.
  • Proporcionar una visión global del tratamiento de los efectos adversos cardíacos de trastuzumab.

Principales métodos:

  • Revisión de la literatura existente sobre la cardiotoxicidad de trastuzumab.
  • Se analizarán las herramientas de diagnóstico como la ecocardiografía, los biomarcadores cardíacos (troponina I, NT-proBNP) y la resonancia magnética.
  • Análisis de las intervenciones farmacológicas actuales y emergentes.

Principales resultados:

  • La cardiotoxicidad es una preocupación significativa con el tratamiento con trastuzumab.
  • El diagnóstico precoz es posible a través de la evaluación de la función cardíaca y los biomarcadores.
  • Los tratamientos establecidos para la insuficiencia cardíaca (por ejemplo, bloqueadores beta, inhibidores de la ECA) y los agentes más nuevos (por ejemplo, ARNIs, inhibidores de SGLT2) son prometedores.
  • Los inhibidores de PCSK9 también están siendo investigados por sus efectos cardioprotectores.

Conclusiones:

  • El tratamiento eficaz de la cardiotoxicidad por trastuzumab requiere un enfoque multifacético.
  • El monitoreo de la función cardíaca y el uso de herramientas de diagnóstico adecuadas son esenciales.
  • Las intervenciones farmacológicas, incluidas las terapias establecidas y las nuevas, son fundamentales para prevenir y tratar los eventos adversos cardíacos.