Prognostic role of p53 gene polymorphism in risk assessment of anthracycline-induced cardiotoxicity

Aims. To study the prognostic significance of polymorphism of the p53 gene (polymorphism Arg72Pro exon 4, rs1042522) on the development of cardiotoxic remodeling of the left ventricle and heart failure. Material and methods. A total of 176 women with breast cancer who received anthracycline antibiotics as part of polychemotherapeutic treatment regimens were examined. Based on the results of the survey, 12 months after the end of polychemotherapy, patients in the remission of the underlying disease were divided into 2 groups: patients with cardiotoxic remodeling (52 patients) and women with preserved heart function (124 patients). All patients before the start of the course of chemotherapy, in the dynamics of treatment with anthracyclines and after therapy with such were carried out the study of echocardiographic parameters. All the patients were taken genetic material, followed by typing alleles of the gene for the protein p53 (rs1042522). Results. Analysis of echocardiographic parameters in patients 12 months after the completion of polychemotherapy in comparison with those before treatment showed a significant difference in the final systolic (33 mm [31; 35] and 28 mm [26; 31], p<0.00001) and terminal diastolic dimensions (51 mm [49; 54.5] and 44 mm [42; 48.5], p=0.0003), as well as a significant decrease in the left ventricular ejection fraction (54.5% [51.5; 58] and 65.5% [62; 70], p<0.00001) in the group of women with developed anthracycline cardiotoxicity. The presence of the Arg/Arg genotype was associated with the development of cardiotoxic myocardial damage during polychemotherapy (OR=3.86, 95% C.I.=1.45-10.26, p=0.005). The Pro/Pro genotype has proved to be a protective factor (OR=0.26, 95% C.I.=0.09-0.69, p=0.015). The conclusion. Predicting the cardiotoxicity of chemotherapy using the polymorphism of the p53 gene is an effective measure of early pre-symptom diagnosis of an increased risk of anthracyclineinduced cardiotoxicity.

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P812 A comparative echocardiographic study of young healthy males with early repolarization pattern

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.465 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

A Frigy ◽

I A Szabo ◽

L Kocsis ◽

S Z Laszlo ◽

H Gabor Kelemen ◽

...

Keyword(s):

Mitral Regurgitation ◽

Global Longitudinal Strain ◽

Young Men ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Early Repolarization ◽

Ventricular Ejection Fraction ◽

Significant Difference ◽

Echocardiographic Parameters ◽

Left And Right

Abstract Background Early repolarization pattern (ERP) takes part from the J-wave syndromes and is associated with enhanced ventricular arrhythmogenesis in susceptible individuals. The main reason of our study was, that possible existence of subtle structural and functional cardiac changes related to ERP is still not well estabilished. Methods We compared 32 echocardiographic parameters (standard measures and specle tracking derived strain) of 30 young men (mean age 21.5 years) with ERP and 32 age and body-mass matched young men without ERP. T-test and chi-square test were used for statistical analysis (significant difference if p < 0.05). Results Only the presence of mild mitral regurgitation was significantly more frequent in the ERP group (36.7% vs. 9.5%, p = 0.01). There were no significant differences regarding the other parameters, e.g., the interventricular septum (9.5 mm vs. 9.4 mm, p = 0.97), the end-diastolic diameters of the left and right ventricles (45 mm vs. 46.6 mm, p = 0.11; 34.9 mm vs. 33.8 mm, p = 0.42), the left ventricular ejection fraction ( 62.4% vs. 60.9 %, p = 0,3), the longitudinal diameters of the left and right atrium (51.8 mm vs. 53.1 mm, p = 0.27; 36.8 mm vs. 36.1 mm, p = 0.20), and the left ventricular global longitudinal strain (-21.75% vs. -21.28, p = 0.77). Conclusion In young males with ERP the vast majority of echocardiographic parameters was not different from those measured in their counterparts without ERP. The existence and clinical significance of the more prevalent mild mitral regurgitation in the ERP group has to be confirmed in a larger cohort.

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GENERAL CARDIOVASCULAR RISK AND FUNCTIONAL INDICATORS OF THE PERMANENT ATRIAL FIBRILLATION

Wiadomości Lekarskie ◽

10.36740/wlek201912113 ◽

2019 ◽

Vol 72 (12) ◽

Author(s):

Larysa O Martymianova ◽

Tetiana M Tykhonova ◽

Olga Yu. Bychkova ◽

Nataliia V Lysenko ◽

Nadiya Ye Barabash

Keyword(s):

Atrial Fibrillation ◽

Cardiovascular Risk ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Power Indices ◽

Ventricular Ejection Fraction ◽

Functional Parameters ◽

Increased Risk ◽

Medical Diagnostic ◽

Echocardiographic Parameters

Introduction: No doubt today that atrial fibrillation (AF) is associated with an increased risk of thromboembolic events. Simultaneously we did not find any investigation about the links between general cardiovascular risk (GCVR) and the frequency forms and functional parameters of the heart in patients with AF. The aim:To study the frequency forms and functional indices of the heart in patients with permanent AF in GCVR groups. Materials and methods: 157 patients with permanent AF (99 men and 58 women) aged 64.6 ± 9.7 years were examined. The frequency of ventricular contractions, the duration of the ventricular complex (QRS), the corrected QT interval (QTc), power indices of the spectrum of heart rate variability (HRV) were measured by ECG. Echocardiographic parameters were studied using a SIM 5000 plus medical diagnostic automated echocardiograph. Patients were classified into GCVR groups. Results and conclusions: The existence of relationships of GCVR with frequency forms of AF and functional indicators of the heart was established. In patients of the class I-III GCVR groups, the tachysystolic form of AF prevailed. Its frequency increases with the rise of the GCVR class. In GCVR IV, redistribution of forms of AF occurs in the direction of normosystolic ones. Among the functional parameters of the heart, the left ventricular ejection fraction and the power of the HRV spectra are most closely associated with GCVR.

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Abstract 265: Genetic Polymorphisms in Angiotensinogen Gene as Potential Modifiers of Hypertrophic and Dilated Cardiomyopathy Phenotypes

Circulation Research ◽

10.1161/res.111.suppl_1.a265 ◽

2012 ◽

Vol 111 (suppl_1) ◽

Author(s):

Bindu Rani ◽

Ajay Bahl ◽

Madhu Khullar

Keyword(s):

Dilated Cardiomyopathy ◽

Disease Severity ◽

Interventricular Septum ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Disease Heterogeneity ◽

Ventricular Ejection Fraction ◽

Increased Risk ◽

Significant Difference ◽

Agt Gene

Background: Hypertrophic Cardiomyopathy (HCM) and Dilated cardiomyopathy (DCM) are diseases of mutant sarcomeric proteins. However, there is marked variation in disease severity and progression, even among patients with identical causal mutation. The renin- angiotensin system plays a major role in the pathophysiology of heart failure and genetic variations in these genes may modulate the risk of disease and be partly responsible for the disease heterogeneity and severity. OBJECTIVE: To evaluate the association of angiotensinogen (AGT) gene polymorphisms (T174M and M235T) with risk of developing severe disease phenotype in HCM and DCM patients. MATERIAL AND METHODS: 275 prospectively enrolled patients (122 HCM and 153 DCM) and 200 normal controls were genotyped for T174M and M235T polymorphisms of AGT gene. Effect of AGT genotypes on interventricular septum thickness and left ventricular ejection fraction (LVEF) were analyzed using linear regression model. RESULTS: We observed significantly higher prevalence of 235T allele in DCM patients which was associated with increased risk of DCM (OR 2.37, CI 1.07-5.25, p=0.04), however T174M polymorphism did not show a significant association with risk of DCM (OR 1.1, CI 0.65-1.84, p=0.79). The frequency of 174M allele was significantly higher in HCM patients as compared to controls and associated with increased risk of HCM (OR 1.95, CI 1.16-3.25, p=0.01), but no significant association of M235T polymorphism was observed with HCM (OR=1.10, CI 0.54-2.22,p=0.8). We did not observe any significant difference in mean LVEF in DCM patients carrying either M235 allele or 235T allele (M235: 27.22±7.13; 235T: 28.60±10.40; p=0.6) or carrying T174 allele or 174M allele (28.83±10.34 vs 28.09±9.93; p=0.7). No significant difference in left ventricular hypertrophy (LVH, mean septal thickness) was observed between 235T and M235 allele carriers [(24.07±5.16mm vs 23.26±6.04mm, p=0.6] or between 174M and T174 allele carriers (T174: 23.41±5.12mm, 174M: 22.83±7.17mm; p=0.6) in HCM patients. CONCLUSION: The variant AGT M235T and AGT T174M alleles confer increased risk of DCM and HCM respectively, but do not appear to be associated with disease severity or progression in these patients.

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

Circulation ◽

10.1161/circ.138.suppl_1.17252 ◽

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.

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THE ROLE OF CARDIAC BIOMARKERS AS PREDICTORS OF TRASTUZUMAB CARDIOTOXICITY IN PATIENTS WITH BREAST CANCER

Experimental Oncology ◽

10.31768/2312-8852.2015.37(1):53-57 ◽

2015 ◽

Vol 37 (1) ◽

pp. 53-57 ◽

Cited By ~ 15

Author(s):

Y Urun ◽

G Utkan ◽

B Yalcin ◽

H Akbulut ◽

H Onur ◽

...

Keyword(s):

Breast Cancer ◽

Diabetes Mellitus ◽

Heart Failure ◽

Left Ventricular ◽

Cardiac Biomarkers ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Her2 Breast Cancer ◽

Increased Risk ◽

Significant Difference

Aim: Identification of patient with increased risk of cardiotoxicity would allow not only prevention and early diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy. Materials and methods: Fiftytwo women with HER2+ breast cancer treated with trastuzumab were included in this study. Patients were prospectively followed with routine cardiac evaluation. Before and after administration of trastuzumab blood samples for NT-proBNP were also taken. Results: The median age was 48.5 year (range: 26–74). Hypertension and obesity were two most common co-morbidities. The median duration application of trastuzumab was 52 weeks. During median 14.5 (3–33) months follow-up cardiac adverse events occurred in 5 (9.6%) patients and 2 out of 5 was grade III–IV heart failure. Both patients had preserved left ventricular ejection fraction and no symptom of heart failure before trastuzumab but older than 65 years old and had diabetes mellitus and obesity. High level of NT-proBNP (> 300 ng/ml) was observed in both patients and heart failure recovery was not observed. There was statistically significant difference regarding body mass index (p = 0.004) and diabetes mellitus (p = 0.002) between patients with and without cardiotoxicity. Conclusion: Although, cardiac biomarkers still cannot replace routine cardiac monitoring, natriuretic peptides may provide additional tool for detection of patients with high risk of cardiotoxicity and early detection of cardiotoxicity.

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P1500Effects of empagliflozin on cardiac function in patients with type 2 diabetes mellitus: echocardiographic substudy of the EMPA-HEART cardiolink-6 trial

European Heart Journal ◽

10.1093/eurheartj/ehz748.0263 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Cited By ~ 1

Author(s):

K Bami ◽

S Gandhi ◽

H Leong-Poi ◽

A Yan ◽

E Ho ◽

...

Keyword(s):

Right Ventricle ◽

Cardiac Mri ◽

Left Ventricular ◽

Doppler Imaging ◽

Volume Index ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Lv Mass ◽

Significant Difference ◽

Echocardiographic Parameters

Abstract Background The EMPA-HEART trial showed a reduction in left ventricular (LV) mass index by cardiac MRI at 6 months in patients treated with Empagliflozin vs placebo. A secondary analysis of key echocardiographic parameters was performed to provide further insight into the mechanism of LV remodeling. Methods All patients enrolled prospectively underwent transthoracic echocardiography (TTE) at baseline and at 6 months. Measurements were performed according to the American Society of Echocardiography guidelines. Key outcomes of interest included changes in diastolic function and right ventricle parameters at 6 months in patients treated with Empagliflozin vs placebo. Results A total of 97 patients were enrolled (49 treated with Empagliflozin and 48 in the placebo group). There was no significant difference in the change in average E/E' at 6-months in the Empagliflozin group vs placebo (−0.4 vs +0.2, adjusted difference −0.2, 95% CI [−1.3 to 0.82], p=0.7) Similarly, there was no difference between the groups in secondary TTE parameters (Table 1). Subgroup analyses showed no benefit among patients with baseline LVEF >50% vs. ≤50%, and baseline LV mass index ≥60 g/m2 vs <60 g/m2. Echocardiographic Parameter Placebo (n=48) Empagliflozin (n=49) Adjusted Difference Between Groups 95% CI P-Value Baseline 6 months Change Baseline 6 months Change LVEF (%)* 55.5 (8.7) 54.3 (8.9) −1.0 (6.5) 58.0 (7.5) 59.1 (8.57) 0.72 (5.1) 2.2 (−0.2, 4.7) 0.1 Diastolic Parameters: Average E/e' 10.1 (3.1) 10.3 (2.5) 0.2 (3.0) 10.6 (3.0) 10.5 (3.6) −0.4 (2.5) −0.2 (−1.3, 0.8) 0.7 Medial E/e' 12.3 (3.9) 12.5 (3.6) 0.1 (3.7) 12.6 (4.2) 12.6 (5.2) −0.3 (3.3) −0.3 (−1.7, 1.1) 0.7 Lateral E/e' 8.0 (2.8) 8.2 (2.2) 0.2 (2.7) 8.7 (2.6) 8.4 (2.5) −0.4 (2.7) −0.1 (−1.0, 0.8) 0.8 E velocity (cm/sec) 68.6 (15.2) 70.6 (14.7) 1.8 (15.4) 74.4 (18.2) 71.2 (16.8) −3.2 (15.1) −2.3 (−7.9, 3.3) 0.4 A velocity (cm/sec) 74.7 (17.9) 77.9 (18.8) 2.9 (15.9) 76.2 (16.5) 75.8 (14.5) −1.4 (11.7) −3.5 (−8.9, 1.6) 0.2 LA volume index (mL/m2) 32.7 (7.9) 30.8 (8.1) −2.0 (6.7) 30.2 (6.7) 28.7 (5.5) −1.6 (6.5) −0.9 (−3.4, 1.6) 0.5 RV Parameters: TAPSE (cm) 1.8 (0.5) 1.8 (0.4) 0.1 (0.4) 2.0 (1.2) 1.8 (0.4) −0.3 (1.4) −0.1 (−0.3, 0.1) 0.3 RV S' TDI (cm/sec) 10.9 (2.9) 10.6 (2.5) −0.1 (2.2) 10.4 (2.7) 10.2 (2.6) −0.4 (2.0) −0.3 (−1.2, 0.5) 0.4 *Measured by cardiac MRI. LA, left atrium; LVEF, left ventricular ejection fraction; RV, right ventricle; TAPSE, tricuspid annular plane systolic excursion; TDI, tissue Doppler imaging. Data expressed as mean (standard deviation). Conclusion This study showed no significant change in key echocardiographic parameters in patients treated with Empagliflozin, suggesting that changes in loading conditions induced by empagliflozin (i.e. preload) do not mediate the reduction in LV mass.

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Atrial fibrillation and risk of incident heart failure with reduced versus preserved ejection fraction

Heart ◽

10.1136/heartjnl-2021-319122 ◽

2021 ◽

pp. heartjnl-2021-319122

Author(s):

Charles D Nicoli ◽

Wesley T O’Neal ◽

Emily B Levitan ◽

Matthew J Singleton ◽

Suzanne E Judd ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Ejection Fraction ◽

Racial Differences ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Preserved Ejection Fraction ◽

Ventricular Ejection Fraction ◽

Increased Risk ◽

Significant Difference

ObjectiveAssociations between atrial fibrillation (AF) and heart failure (HF) have been established. We compared the extent to which AF is associated with each primary subtype of HF, with reduced (HFrEF) versus preserved ejection fraction (HFpEF).MethodsWe included 25 787 participants free of baseline HF from the REGARDS (REasons for Geographic And Racial Differences in Stroke) cohort. Baseline AF was ascertained from ECG and self-reported history of physician diagnosis. Incident HF events were determined from physician-adjudicated review of hospitalisation medical records and HF deaths. Based on left ventricular ejection fraction (LVEF) at the time of HF event, HFrEF, HFpEF, and mid-range HF were defined as LVEF <40%, ≥50% and 40%–49%, respectively. Multivariable Cox proportional-hazards models examined the association between AF and HF. The Lunn-McNeil method was used to compare associations of AF with incident HFrEF versus HFpEF.ResultsOver a median of 9 years of follow-up, 1109 HF events occurred (356 HFpEF, 388 HFrEF, 77 mid-range and 288 unclassified). In a model adjusted for sociodemographics, cardiovascular risk factors, and incident coronary heart disease, AF was associated with increased risk of all HF events (HR 1.67, 95% CI 1.38 to 2.01). The associations of AF with HFrEF versus HFpEF events did not differ significantly (HR 1.87 (95% CI 1.38 to 2.54) and HR 1.65 (95% CI 1.20 to 2.28), respectively; p value for difference=0.581). These associations were consistent in sex and race subgroups.ConclusionsAF is associated with both HFrEF and HFpEF events, with no significant difference in the strength of association among these subtypes.

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A case series about the favorable effects of sacubitril/valsartan on anthracycline cardiomyopathy

SAGE Open Medical Case Reports ◽

10.1177/2050313x20952189 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2095218

Author(s):

Renato De Vecchis ◽

Andrea Paccone

Keyword(s):

Case Series ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Angiotensin Receptors ◽

Anthracycline Cardiotoxicity ◽

Ventricular Ejection Fraction ◽

Anthracycline Cardiomyopathy ◽

Cardiac Decompensation ◽

Hematological Cancers ◽

Echocardiographic Parameters

Anthracyclines are the cornerstone of treatment for many solid and hematological cancers such as breast cancer or lymphoma for the past 50 years. Nevertheless, in a non-negligible proportion of patients, they elicit dilated cardiomyopathy as a side effect, which causes in turn cardiac decompensation. Conversely, for some years, sacubitril/valsartan has been proposed as a new therapeutic paradigm for all varieties of heart failure with reduced left ventricular ejection fraction, due to its balanced enhancement of natriuretic peptides’ properties coupled with a blocking effect on the AT1 angiotensin receptors. In this article, two clinical cases are illustrated in which the therapeutic action of sacubitril/valsartan against anthracycline cardiomyopathy would seem to be demonstrated by the improvement of symptoms and echocardiographic parameters. Thus, further studies would be warranted for better evaluating the potential role of sacubitril/valsartan as a novel therapeutic tool against anthracycline cardiotoxicity.

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Rage Gene Polymorphism in Heart Failure Patients with and without Angiographic Evidence of Significant Coronary Atherosclerosis

International Journal of Immunopathology and Pharmacology ◽

10.1177/039463201302600119 ◽

2013 ◽

Vol 26 (1) ◽

pp. 199-206

Author(s):

C. Falcone ◽

S. Bozzini ◽

B. Matrone ◽

A. Colonna ◽

R. Falcone ◽

...

Keyword(s):

Heart Failure ◽

Gene Polymorphism ◽

Protective Role ◽

Left Ventricular ◽

Pharmacological Therapy ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Genetic Components ◽

Significant Difference

Heart failure (HF) is a multifactorial disorder in which clinical, environmental and genetic components take part. For this reason it is possible that common gene variants could affect development, progression and response to pharmacological therapy. In recent years the role of AGEs in the pathogenesis of cardiovascular diseases has become recognized but little is known about the role of the AGE-RAGE system in heart failure. The aim of the present study was to identify possible relationship between -374 T/A RAGE gene polymorphism with heart failure. The population in this study consists of 386 subjects with HF, selected according to the presence of depressed Left Ventricular Ejection Fraction (LVEF) <45%, and 639 patients with CAD documented at coronary angiography. Within the population with HF there are 228 patients with disease secondary to not ischemic cause and 158 with post-ischemic condition. The sample of AA genotype was significantly lower in patients with post-ischemic HF in respect to HF secondary to non-ischemic causes (p<0.001). A significant difference between the two groups was also observed regarding the allele frequency. In addition, differences in the allelic and the genotypic frequencies of homozygous genotypes were found between the HF patients free from evidence of coronary significant lesions and patients with at least one hemodynamically significant coronary lesion, both HF and CAD. In patients with at least one vessel compromised the presence of A allele and the homozygous AA genotype were significantly lower than in patients with lesion-free coronary. In conclusion, our research reveals that the -374 T/A polymorphism is related to the genesis of atherosclerotic coronary artery disease but not to its evolution. The protective role of AA genotype in respect to atheromatous disease is therefore confirmed also in the HF population with non-ischemic origin.

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An Unusual Association: Right Atrial Myxoma and Severe Left Ventricular Dysfunction. Case Report and Review of the Literature

The Heart Surgery Forum ◽

10.1532/hsf98.2014420 ◽

2015 ◽

Vol 17 (6) ◽

pp. 285

Author(s):

Lucian Florin Dorobantu ◽

Ovidiu Chioncel ◽

Alexandra Pasare ◽

Dorin Lucian Usurelu ◽

Ioan Serban Bubenek-Turconi ◽

...

Keyword(s):

Ejection Fraction ◽

Ventricular Dysfunction ◽

Left Ventricular Systolic Dysfunction ◽

Left Ventricular ◽

Right Atrial ◽

Left Ventricular Ejection ◽

Cardiac Tumors ◽

Severe Left Ventricular Dysfunction ◽

Ventricular Ejection Fraction ◽

Increased Risk

Myxomas comprise 50% of all benign cardiac tumors in adults, with the right atrium as their second most frequent site of origin. Surgical resection is the only effective therapeutic option for patients with these tumors. The association between right atrial myxomas and severe left ventricular systolic dysfunction is extremely rare and makes treatment even more challenging. This was the case for our patient, a 47-year-old male with a right atrial mass and a severely impaired left ventricular function, with a 20% ejection fraction. Global enlargement of the heart was also noted, with moderate right ventricular dysfunction. The tumor was successfully excised using the on-pump beating heart technique, with an immediate postoperative improvement of the left ventricular ejection fraction to 35%. The technique proved useful, with no increased risk to the patient.

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