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特拉斯图祖马布诱导的延迟心脏毒性导致严重的左心室功能障碍
Ikuo Misumi1, Reiki Nishimura2, Shota Nakamura3
1Department of Cardiology, Ueki Hospital, Japan.
Internal medicine (Tokyo, Japan)
|October 20, 2024
概括
这项案例研究突出了老年女性特斯图祖马布诱导的延迟心肌损伤. 连续心脏成像显示,在停止治疗后,心脏功能显著改善.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 特拉斯图祖马布是一种用于癌症治疗的向疗法.
- 心脏毒性是trastuzumab已知的副作用之一,通常在治疗早期出现.
- 延迟发作的心脏毒性不太常见,但需要谨慎监测.
研究的目的:
- 为了呈现一例拖延后的trastuzumab诱导的心肌损伤的情况.
- 为了说明串行心脏成像在评估心脏功能和结构中的实用性.
- 强调治疗trastuzumab的患者长期心脏监测的重要性.
主要方法:
- 一个病例报告,一名81岁的妇女在经历了九年后出现呼吸障碍,她接受了trastuzumab治疗.
- 诊断成像包括胸部放射,胸前心声和心脏磁共振成像 (CMR).
- 进行了串行心声扫描,以随着时间的推移监测左心室喷射率 (LVEF).
主要成果:
- 胸部X射线扫描显示了多叶膜溢出.
- 胸外心声图显示了腹腔间隔膜 (IVS) 功能障碍.
- CMR显示心肌胀或肌纤维化在心室间隔膜和顶部.
- 在最初评估后的六个月内,LVEF从25%提高到48%.
结论:
- 拖延后祖马布诱导的心肌损伤可能发生在治疗开始后的几年.
- 在这种情况下,串行胸前回声心脏成像和CMR是评估心脏结构和功能的宝贵工具.
- 长期的心脏监测对于接受trastuzumab治疗的患者至关重要.
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