心脏移植在患有 antracycline 诱导的心肌病的患者中
Santiago L Del-Castillo1, Santiago Decotto1, María M Fleitas1
1Department of Cardiology.
Archivos de cardiologia de Mexico
|November 16, 2023
概括
心脏移植可能是一个可行的选择,对于严重的环素诱导心肌病 (ACM) 的患者. 长期的心血管监测是至关重要的,因为化学疗法后的ACM可能会出现延迟.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 移植医学 移植医学
背景情况:
- 抗环素化疗可以导致晚期发病,末期心肌病.
- 人类环素诱导的心肌病 (ACM) 需要先进的治疗策略.
研究的目的:
- 详细介绍为ACM进行心脏移植的患者的临床和成像特征.
- 描述这些患者的移植后结果和演变.
主要方法:
- 在2009年11月至2021年4月期间,对11名接受心脏移植ACM的患者进行了回顾性分析.
- 从电子医疗记录收集临床数据,移植前评估和移植后结果.
主要成果:
- 癌症诊断时的中位数年龄为15岁,心脏移植时的中位数年龄为56岁.
- 在11名患者中,有7人经历了移植后的良好后果.
- 三名患者在手术后的早期死亡,一名患者在4年后因慢性排斥而死亡.
- 在平均2.5年的随访期间,没有观察到瘤复发.
结论:
- 化学疗法后多年ACM可能出现,这强调了需要警的心血管监测.
- 心脏移植是末期ACM的可行的治疗方法,需要仔细的多学科评估以减轻瘤风险.
相关概念视频
Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
Cardiomyopathy III: Hypertrophic Cardiomyopathy
15
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...
15
Cardiomyopathy V: Interprofessional Care
14
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...
14
Heart Failure Drugs: Inotropic Agents
596
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...
596
Cardiomyopathy IV: Restrictive Cardiomyopathy
12
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
12
Myocarditis III: Medical Management
7
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...
7


