Cardiovascular toxicity follwing sunitinib therapy in metastatic renal cell cancer: A multicenter analysis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16051-e16051
Author(s):  
G. Di Lorenzo ◽  
S. De Placido ◽  
G. Cartenì ◽  
R. Autorino ◽  
A. Gonnella ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Renal Cell ◽  
Cell Cancer ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Increased Risk ◽  
History Of ◽  
Grade 3

e16051 Background: Recent data have shown that cardiotoxicity represents a potentially important side-effect in patients treated with sunitinib. We reviewed cardiac adverse events in patients with metastatic renal cell carcinoma (RCC) who underwent treatment with this agent. Methods: The medical records of 175 patients with metastatic RCC treated with sunitinib at eight Italian Institutions were retrospectively reviewed. Alterations in left ventricular ejection fraction (LVEF) and blood pressure were evaluated. Patients with pre-existing cardiac risk factors were specifically scrutinized for increased expression of cardiac changes. Results: Grade 3 hypertension was seen in 17 patients (9.7%); in twelve of these 17, hypertension developed after receiving the third sunitinib cycle. Among these 17 patients, 12 (70.6%) also experienced left-ventricular systolic (LVEF) dysfunction; in all, 33 of the 175 patients (18.9%) developed some degree of cardiac abnormality, of which 12 were of classified as grade 3 LVEF dysfunction and/or congestive heart failure (CHF) (6.9%). A significant univariate association for predictors of CHF were history of hypertension (p=0.008), history of coronary heart disease (p=0.0005) and prior treatment with an angiotensin converting enzyme inhibitor (ACE) (p= 0.04). Multivariate analysis suggested that a history of coronary artery disease (OR 18, 95% CI, 4–160 p 0.005) and hypertension (OR 3, 95% CI, 1.5–80 p 0.04) were the only significant independent predictors of CHF. Conclusions: Patients undergoing sunitinib, especially those with a previous history of hypertension and coronary heart disease, are at increased risk for cardiovascular events and should be monitored for exacerbations of their hypertension and for evidence of LVEF dysfunction during treatment. [Table: see text]

scholarly journals THE REMODELING OF LEFT ATRIUM AND VASODILATION FACTORS CHANGES IN ISCHEMIC HEART FAILURE

2017 ◽  
Author(s):  
V. I. Denesyuk ◽  
O. V. Denesyuk ◽  
N. O. Muzyka
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Atrium ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Stable Coronary Heart Disease

Background. According to the national registries of European countries and epidemiological studies, the prevalence of chronic heart failure (CHF) among adults is 2,0-5,0%, and increases due to age, in people aged over 70 years old it is 10,0-20,0%.Objective. To find out the specific features of remodeling of the left atrium and change of vasodilation factors in ischemic heart failure with reduced and preserved left ventricular ejection fraction and to establish correlation relationships.Methods. A full clinical examination of 153 patients with CHF (105 men and 48 women) was conducted to achieve this objective. The surveyed patients underwent clinical examinations; spectrophotometric parameters: quantification of markers of vasodilation, metabolites of monoxide nitrogen – nitrates and nitrites with Gris reagent; content of endothelial nitric oxide synthase (eNOS) in serum - ELISA for the set of Nitric Oxide Synthase 3, Endothelial (NOS3) Human ELISA Kit (Cloud-Clone Corp, USA). Electrocardiographic (ECG) examination was conducted in 12 standard conventional leads on electrocardiograph by the Hungarian production Heart Screen 112 D.Results. The 1st group of the examined patients with reduced LV EF prevails III (significant) degree LA dilatation in 33 (70.21%) cases, II (moderate) degree of LA dilatation was determined in 14 (29.78%), and I (initial) degree was not defined at all. In the 2nd group of the patients with preserved LV EF mainly the II degree of LA dilatation was determined in 44 (44.51%) cases, and decreased LA dilation in 39 (36.79%) cases (p<0.01), and III degree of LA dilation was defined in 23 (21.69%) cases (p<0.01). In patients with stable coronary heart disease, complicated by heart failure with reduced LV EF and II degree of LA dilatation, eNOS levels in the serum was 449.00±39.91 pg/ml, whereas in patients with stable coronary heart disease, complicated by heart failure with preserved LV EF and II stage of LA dilatation – 673.56±50.98 pg/ml (p<0.01). At III stage of LA dilatation in patients of the 1st group level eNOS was 344.20±51.98 pg/ml in the patients of the 2nd group – 616.90±36.49 pg/ml (p<0.01). At the same degree and with LA dilation in the patients of the 2nd group eNOS was 750.27±99.85 pg/ml. Conclusions. The structural and functional changes of the left atrium and changing factors of vasodilation in patients with stable coronary artery disease of II-III functional classes complicated by heart failure of I-III functional classes are studied. It is established that in the examined patients with stable coronary heart disease complicated by heart failure with reduced left ventricular ejection fraction mainly III (significant) degree of dilatation of the left atrium was determined, while in patients with stable coronary heart disease, complicated by heart failure with preserved left ventricular ejection fraction mainly II (moderate) degree of dilation of the left atrium was determined. In comparison with the results of research among the patients with stable coronary heart disease, complicated by heart failure with reduced left ventricular ejection fraction, and a group of patients with preserved left ventricular ejection fraction, it was determined a significant decrease in eNOS, nitrites, total amount of nitrites and nitrates.

scholarly journals LITERATURE REVIEW: EFFECTIVENESS OF CARDIAC REHABILITATION IN PATIENTS WITH CORONARY HEART DISEASE

2020 ◽  
Vol 4 (2) ◽  
pp. 141-152
Author(s):  
Ika Ainur Rofi'ah ◽  
Eka Nur So'emah
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Literature Review ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: Cardiac rehabilitation is an evidence-based intervention that includes physical exercise, health education, and modification of health behavior in patients with cardiovascular disease. Cardiac rehabilitation is considered as secondary prevention after acute coronary syndrome and improves treatment outcomes in patients with coronary heart disease. This literature review aimed to evaluate the effectiveness of cardiac rehabilitation in coronary heart disease patients. Methods: This present study was a literature review discussing cardiac rehabilitation for coronary heart disease patients. Results: The result showed that the functional capacity of the CR group was more increased compared to non-CR (p <0.001; α <0.05), left ventricular ejection fraction (LVEF) significantly increased in the CR group (p < 0.05; α <0.05), the medical cost of CR group was lower significantly (p=0.042; α <0.05), and the risk of recurrence rate was significantly lower in CR group (p=0.004; α <0.05). Conclusions: Cardiac rehabilitation is known to increase functional capacity, increase left ventricular ejection fraction (LVEF), reduce medical costs, and reduce the recurrence rate of patients with CHD.

scholarly journals Relação entre classe funcional e fração de ejeção do ventrículo esquerdo em pacientes com doença coronariana candidatos à reabilitação cardíaca

2017 ◽  
Vol 27 (3) ◽  
pp. 26652
Author(s):  
Isabella Martins de Albuquerque ◽  
Andrieli Barbieri Garlet ◽  
Dannuey Machado Cardoso ◽  
Tamires Daros Santos ◽  
Sérgio Nunes Pereira
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Medical Records ◽  
Left Ventricular ◽  
Functional Class ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

***Relationship between functional class and left ventricular ejection fraction in patients with coronary heart disease who were candidates for cardiac rehabilitation***AIMS: To assess the potential relation between the New York Heart Association functional class and left ventricular ejection fraction in coronary heart disease patients who were candidates for cardiac rehabilitation.METHODS: This is a retrospective cross-sectional study based on the analysis of medical records of coronary heart disease patients who were candidates for the Cardiac Rehabilitation Program of Hospital Universitário de Santa Maria, state of Rio Grande do Sul, Brazil. Both male and female patients aged 50 to 65 were included, whereas patients with chronic renal failure, anemia, poor echocardiographic image quality, non-sinus rhythm, and also those individuals whose medical records lacked sufficient information were excluded. Data were collected from August 2015 to March 2016, and the information that made up the variables of interest was extracted from the medical records, such as: clinical and demographic data (sex, age, comorbidities, clinical diagnosis, surgical and drug treatment), left ventricular ejection fraction values obtained by echocardiography (conventional and tissue Doppler echocardiography), and functional class from the ergometric test. Statistical analysis was performed using Kruskal-Wallis test followed by Dunn’s post-hoc test.  The significance level was set at p<0.05.RESULTS: A total of 131 medical records were consecutively evaluated, of which 102 met the inclusion criteria. Mean age was 59.23±7.95 years and 70 (68.63%) patients were male, with a predominance of functional class I. There was an inverse relation between functional class and ejection fraction: the more advanced the functional class, the more compromised the cardiac performance (p=0.036).CONCLUSIONS: In this sample of patients with coronary heart disease who were candidates for cardiac rehabilitation, there was an inverse relation between left ventricular ejection fraction and functional class. This finding provides information about the limitations imposed by the disease on patient’s exercise capacity and heart function and can contribute to the development of a physical training program.

Abstract 17252: Left Ventricular Noncompaction in Patients With Preserved Ejection Fraction is Associated With Increased Cardiac Hospitalizations

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Vikashsingh Rambhujun ◽  
Vijayapraveena Paruchuri ◽  
Abdul Moiz Hafiz ◽  
Catherine Kreatsoulas ◽  
Joshua DeLeon ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ejection Fraction ◽  
Cardiac Mri ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Ventricular Ejection Fraction ◽  
Increased Risk ◽  
Significant Difference ◽  
And Function

Introduction: Prominent left ventricular trabeculations or left ventricular non-compaction (LVNC) is observed now more often with cardiac magnetic resonance imaging (MRI). The significance of LVNC in patients with preserved ejection fraction remains unknown however it may be a precursor to cardiomyopathy. Hypothesis: This study is aimed to evaluate the clinical outcome of patients with LVNC and preserved LV function compared to patients with normal myocardial anatomy and function. Methods: This is a retrospective analysis of patients referred for cardiac MRI between October 2012 and July 2017. Patients with hypertrophic cardiomyopathy, ischemic heart disease and infiltrative heart disease were excluded. Patients with prominent trabeculations and a noncompacted to compacted myocardial ratio ≥ 2.3 with a preserved left ventricular ejection fraction of ≥ 50% were included. The primary outcome is defined as cardiac hospitalizations resulting from chest pain, arrhythmias, syncope, and congestive heart failure. These patients were compared to patients who underwent cardiac MRI with preserved function and normal myocardial anatomy. Results: There were a total of 39 patients who met criteria of LVNC with preserved function by MRI. These were compared to 59 patients with preserved function and normal myocardial anatomy on MRI. There was no significant difference in demographics and LV size and function between the groups. In comparison with the control group, the LVNC group had a mean age of 44 ± 14 versus 42 ± 16, 62% female sex versus 59%, LV EF of 59 ± 5% versus 62 ± 6%, LV end diastolic volume of 148 ± 26 ml versus 146 ± 40 ml. There were a total of 7 cardiac hospitalizations, of which 5 occurred in patients with LVNC. LVNC was associated with a greater than 4-fold increased risk of events (HR4.6, 95%CI 1.0-21.8) (figure) Conclusions: In patients with preserved EF, LVNC anatomy is significantly associated with increased cardiac hospitalizations.

P1575Cardiovascular toxicity following modern multiple myeloma therapy in Japanese cohort

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Shibata ◽  
S Nohara ◽  
K Nagafuji ◽  
Y Fukumoto
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Multiple Myeloma ◽  
Troponin I ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prior History ◽  
Ventricular Ejection Fraction ◽  
Increased Risk ◽  
History Of

Abstract Background Multiple myeloma (MM) is a plasma cell dyscrasia accounting for approximately 13% of hematologic malignancies. Patients with MM have an increased risk of cardiovascular adverse events (CAEs) due to disease burden and/or anti-myeloma treatment-related risk factors. However, little is known about the incidence of cardiovascular toxicity of patients with MM. Methods We analyzed 42 consecutive patients (Male/Female 22/20, age 67±10 years old) who received anti-MM therapies between October 2016 and September 2018 from our University Cardio-REnal Oncology (CREO) registry. We examined the incidence of CAEs through January 2019 including congestive heart failure and cardiomyopathy (CHF/CM), ischemic cardiac event, newly symptomatic arrhythmias included atrial fibrillation or flutter requiring treatment, and venous thromboembolism (VTE). Results Within the 408-day median follow-up period (range 15–844 days), CAEs occurred in 23.8% (n=10); CHF/CM in 11.9%, newly diagnosed atrial fibrillation in 4.8%, VTE in 4.8%, vasospastic angina in 2.4%, and death in 28.6%. There were no significant differences between CAEs group and non-CAEs group in terms of sex, body mass index (BMI), incidence of hypertension, ischemic heart disease, prior history of heart failure, cardiovascular medications, left ventricular ejection fraction, serum high-sensitivity troponin-I, estimated glomerular filtration rate, blood urea nitrogen and N-terminal pro-brain natriuretic peptide levels at the time of enrollment. The use of various types of proteasome inhibitors and immunomodulatory drugs were not associated with the increased risk of CAEs. By multivariate analysis, a history of prior anti-myeloma therapies was identified as an independent risk factor for CAEs. Conclusion CAEs were significantly associated with the recurrent MM in Japanese MM patients.

scholarly journals Relação entre classe funcional e fração de ejeção do ventrículo esquerdo em pacientes com doença coronariana candidatos à reabilitação cardíaca

2017 ◽  
Vol 27 (3) ◽  
pp. 26652
Author(s):  
Isabella Martins de Albuquerque ◽  
Andrieli Barbieri Garlet ◽  
Dannuey Machado Cardoso ◽  
Tamires Daros Santos ◽  
Sérgio Nunes Pereira
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Medical Records ◽  
Left Ventricular ◽  
Functional Class ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

***Relationship between functional class and left ventricular ejection fraction in patients with coronary heart disease who were candidates for cardiac rehabilitation***AIMS: To assess the potential relation between the New York Heart Association functional class and left ventricular ejection fraction in coronary heart disease patients who were candidates for cardiac rehabilitation.METHODS: This is a retrospective cross-sectional study based on the analysis of medical records of coronary heart disease patients who were candidates for the Cardiac Rehabilitation Program of Hospital Universitário de Santa Maria, state of Rio Grande do Sul, Brazil. Both male and female patients aged 50 to 65 were included, whereas patients with chronic renal failure, anemia, poor echocardiographic image quality, non-sinus rhythm, and also those individuals whose medical records lacked sufficient information were excluded. Data were collected from August 2015 to March 2016, and the information that made up the variables of interest was extracted from the medical records, such as: clinical and demographic data (sex, age, comorbidities, clinical diagnosis, surgical and drug treatment), left ventricular ejection fraction values obtained by echocardiography (conventional and tissue Doppler echocardiography), and functional class from the ergometric test. Statistical analysis was performed using Kruskal-Wallis test followed by Dunn’s post-hoc test.  The significance level was set at p<0.05.RESULTS: A total of 131 medical records were consecutively evaluated, of which 102 met the inclusion criteria. Mean age was 59.23±7.95 years and 70 (68.63%) patients were male, with a predominance of functional class I. There was an inverse relation between functional class and ejection fraction: the more advanced the functional class, the more compromised the cardiac performance (p=0.036).CONCLUSIONS: In this sample of patients with coronary heart disease who were candidates for cardiac rehabilitation, there was an inverse relation between left ventricular ejection fraction and functional class. This finding provides information about the limitations imposed by the disease on patient’s exercise capacity and heart function and can contribute to the development of a physical training program.

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