Immune Checkpoint Inhibitors-Related Myocarditis: A Review of Reported Clinical Cases

Diagnostics, Journal Year: 2023, Volume and Issue: 13(7), P. 1243 - 1243

Published: March 25, 2023

Myocarditis associated with the use of immune checkpoint inhibitors (ICI) is a rare manifestation their cardiotoxicity, but characterized by high mortality rate. A literature search was conducted using PubMed keywords, which resulted in selection 679 scientific works, from 160 articles that described 244 clinical cases were selected. The median age patients 67 years (IQR, 60–74). time start ICI therapy to development first adverse symptoms 21 days 14–38.3). In 37% cases, myocarditis developed after administration ICI. Cardiac present 47.1% neuromuscular 30.3%, and other 12.6%, while asymptomatic 10.1% cases. New changes electrocardiograms detected 85.1% compared initial data. incidence complete atrioventricular block (25.4%), right bundle branch (18.4%), ventricular tachycardia (13%), sinus (12%) noted. 97% received prednisolone or methylprednisolone therapy. When ICI, special attention should be paid early detection possible cardiotoxicity analyzing condition function myocardium before treatment its dynamics.

Language: Английский

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2024 Clinical practice guidelines for Stable coronary artery disease

Russian Journal of Cardiology, Journal Year: 2024, Volume and Issue: 29(9), P. 6110 - 6110

Published: Aug. 29, 2024

Russian Society of Cardiology (RSC) With the participation of: National for Study Atherosclerosis (NOA), Atherothrombosis Society, Association Cardiovascular Surgeons, Cardiosomatic Rehabilitation and Secondary Prevention (RosOKR), Radiologists (RSRR), Ultrasound Diagnostics Specialists in Medicine (RASUDM), Scientific X-ray Endovascular Diagnosis Treatment

Language: Английский

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Risk factors and prevention of cardiovascular complications in breast cancer

CARDIOVASCULAR THERAPY AND PREVENTION, Journal Year: 2025, Volume and Issue: 23(12), P. 4194 - 4194

Published: Feb. 13, 2025

Breast cancer (BC) is the most common malignant tumor in women. In patients who have undergone antitumor treatment at an early stage of BC, death long term more often occurs from cardiovascular diseases (CVD) than cancer. Numerous studies indicate that risk cardiomyopathy and/or heart failure, coronary artery disease among BC survivors received anthracyclines trastuzumab increased. Currently, detection cardiotoxicity using cardiac imaging and circulating biomarkers widely evaluated clinical trials. At same time, high CVDs observed cured breast a consequence both adverse effects anticancer therapy on system, including antiestrogens, presence CVD factors. Large trials reported higher rates hypertension, hypercholesterolemia, ischemic postmenopausal receiving aromatase inhibitors. Strategies for prevention left ventricular dysfunction or failure such should include comprehensive evaluation individual assessment.

Language: Английский

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Evaluation of local vascular stiffness in patients with malignant neoplasms receiving immune checkpoint inhibitor therapy

Kazan medical journal, Journal Year: 2025, Volume and Issue: 106(1), P. 26 - 34

Published: March 19, 2025

BACKGROUND: Immune checkpoint inhibitors (ICIs) have become a key component of immunotherapy for malignant neoplasms; however, their use is associated with the risk cardiovascular toxicity, presenting significant challenge. AIM: The study aimed to evaluate effect ICI therapy on local vascular stiffness parameters in patients neoplasms. METHODS: This prospective included 47 (27 men and 20 women) mean age 59.5 ± 7.38 years, all whom had been diagnosed specific diagnoses lung cancer (n = 30), melanoma 6), urothelial carcinoma 5), head neck tumors esophageal 1). received ICIs, including nivolumab 9), pembrolizumab 23), atezolizumab 15). control group individuals (10 10 without neoplasms, acute conditions, decompensated chronic non-communicable diseases, or infectious diseases. These underwent evaluation as part preventive medical examination screening. was comparable terms (59.3±6.52 years), sex distribution, prevalence comorbidities. Ultrasound brachiocephalic arteries, calculation parameters, measurement ankle-brachial index were performed dynamically (before initiation anticancer drug three months after treatment initiation). statistical analysis descriptive statistics, Student’s t-test, Mann–Whitney test, Fisher’s exact Pearson’s chi-square (χ²) test. A significance level p 0.05 used analyses. RESULTS: An structural functional wall undergoing demonstrated progression atherosclerotic changes carotid arteries. During therapy, an increase common artery stenosis observed (p 0.05) compared group, along trend toward increased number visualized plaques 0.06). tendency decline distensibility 0.07) Peterson’s modulus elasticity 0.05), Young’s 0.04), 0.09), pulse wave velocity 0.01). values identified 0.001). CONCLUSION: greater severity lesions stiffness, decrease index.

Language: Английский

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Possibilities of dapagliflozin-induced cardioprotection on doxorubicin + cyclophosphamide mode of chemotherapy-induced cardiomyopathy

International Journal of Cardiology, Journal Year: 2023, Volume and Issue: 391, P. 131331 - 131331

Published: Sept. 4, 2023

Language: Английский

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Determining The Risk of Cardio- and Vasotoxicity of Antitumor Therapy: to Whom, When, Why?

Kardiologiia, Journal Year: 2025, Volume and Issue: 65(1), P. 3 - 10

Published: Feb. 5, 2025

It is known that the advances in cancer treatment leading to increased survival malignant neoplasms, entail a variety of adverse cardiovascular toxic effects can be quite serious and even potentially fatal. An important component influences degree cardiotoxicity risk patient’s clinical functional state history at time diagnosis. This information used practice for screening evaluation patient with neoplasm before start antitumor therapy. After completion cardiotoxic therapy, as well during subsequent follow-up, it advisable re-evaluate long-term determine frequency intensity monitoring. For convenience calculating patients undergoing treatment, authors this article have developed two computer programs PC applications (https://disk.yandex.ru/d/NuhzYnicWo9FSw) on mobile devices (https://disk.yandex.ru/d/uXAriKZ6qhkULA.). These facilitate selection correct strategy management aimed reducing likelihood complications treatment.

Language: Английский

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Arterial stiffness and 24-hour blood pressure profile in women with breast cancer before and after chemotherapy with doxorubicin and cyclophosphamide

Russian Journal of Cardiology, Journal Year: 2025, Volume and Issue: 30(2), P. 5920 - 5920

Published: March 14, 2025

Aim. To evaluate arterial stiffness and 24-hour blood pressure (BP) profile in breast cancer (BC) women with normotension, masked hypertension (MH) primary (HTN) before after chemotherapy (CT) a combination of doxorubicin cyclophosphamide. Material methods . The study involved 158 newly diagnosed stage IIA-IIIA BC. Before chemotherapy, the patients were divided into 2 groups. first group included 109 normal clinical BP, second 49 previously 1-2 HTN. 7-14 days its completion, ambulatory BP monitoring (ABPM) noninvasive arteriography performed. mean systolic (SBP) diastolic (DBP), variability, time indices SBP DBP, their nighttime decrease morning rise analyzed. pulse wave velocity (PWV) aorta, augmentation index (AI), central pressure, area ratio determined. Results. According to ABPM conducted start two subgroups identified among examined BP. 55 (50,5%) while — 54 (49,5%) MH. general trend modification was excessive variability tendency towards tachycardia. Doxorubicin cyclophosphamide-based is associated an increase PWV AI all groups subjects, indicating stiffness. These changes more pronounced case comorbidity BC MH Conclusion. In women, comprehensive assessment stiffness, glomerular filtration rate left ventricular myocardial ejection fraction informative tool for timely detection vascular toxicity prevention adverse cardiovascular events.

Language: Английский

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Premature coronary artery disease in a patient with a history of combined treatment for lymphogranulomatosis: a case report

CARDIOVASCULAR THERAPY AND PREVENTION, Journal Year: 2025, Volume and Issue: 24(2), P. 4104 - 4104

Published: Jan. 21, 2025

Introduction. Cancer occupies one of the leading positions in list most common death causes world. The widespread use chemo-, targeted, immune and radiation therapy clinical practice has increased survival cancer patients. However, incidence cardiotoxic complications antitumor significantly, they may manifest themselves many years after onset remission. Brief description. We present a case premature coronary artery disease (CAD) 40-year-old male patient, who underwent multiagent chemotherapy combination with for mediastinal lymph nodes due to lymphogranulomatosis at age 22. In 2021, against background stressful situation, patient first noted burning sensation chest, which was relieved spontaneously, an increase blood pressure 145/90 mm Hg. After visiting cardiologist, clinical, electrocardiographic echocardiographic (at rest) examination performed. no pathology found, not prescribed. Over next 3 years, short-term squeezing pain chest periodically noted, occurring during fast walking, when stopping. April 2024, hospitalized cardiology department University Clinic N. A. Semashko Institute Clinical Medicine Russian in-depth cardiological examination. Analysis complaints anamnestic data, paraclinical examination, made it possible diagnose CAD, class III angina pectoris. This regarded as late manifestation cardiotoxicity area, performed 22 lymphogranulomatosis. Selective angiography revealed multiple stenoses. For myocardial revascularization, referred I. V. Davydovsky City Hospital, where 4 drug-eluting stents were inserted. Follow-up monitoring cardiovascular system carried out. When contacting cardiologist typical insufficiency, CAD diagnosed. Conclusion. presented shows difficulties diagnosing long-term manifestations form CAD. It is necessary conduct additional educational activities introduce modern technological products improve effectiveness primary prevention, diagnosis treatment therapy.

Language: Английский

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Cardio-oncology today: digest of the first European clinical guidelines (2022)

Kardiologiia, Journal Year: 2023, Volume and Issue: 63(7), P. 3 - 15

Published: July 28, 2023

Over the past few decades, due to extensive implementation of cancer screening programs, up-to-date early diagnostic methods, and effective combinations antitumor therapy, it has become possible significantly improve survival patients. At same time, despite treatment malignancies, most patient face adverse often life-threatening effects specific on heart blood vessels. All this resulted in active development a new field cardiology, cardio-oncology. In recent years, based experience leading experts, data from large studies, meta-analyses, both international Russian Consensuses, conciliation documents, have been formed published. These documents regulate principal methodological approaches management control cardiovascular conditions Finally, 2022 was marked by issuing first official European Guidelines Cardio-Oncology history medicine. This article highlights relevant, our opinion, positions these guidelines as well controversial unresolved issues.

Language: Английский

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Diagnostic capabilities of instrumental methods for studying early cardiovascular adverse events in patients with lymphoproliferative disorders, quality and safety issues

CARDIOVASCULAR THERAPY AND PREVENTION, Journal Year: 2024, Volume and Issue: 23(2), P. 3784 - 3784

Published: Jan. 29, 2024

Aim . To study the possibilities of instrumental research methods in relation to earliest detection cardiovascular events oncohematological patients receiving antitumor immunochemotherapy, as well deter­mine requirements for documenting adverse events. Material and For study, 63 were prospectively selected with a diagnosis indolent non-Hodgkin lymphoma, who indicated immunochemotherapy. The examined three stages (before treatment, after 3 6 cycles therapy) divided into 2 groups by simple randomization. Cardiovascular toxicity main group was assessed using 3D transthoracic echocardiography, analysis left ventricular (LV) global longitudinal systolic strain electrocardiography. control underwent standard echocardiography LV ejection fraction. Clinical manifestations all during treatment. Results According significant changes obtained fraction on third visit — decrease from 58,9±1,07 48,1±0,73% (p<0,05) 57,7±1,13 49,4±0,58% |21,1±1,18 |14,0±1,61 |% group. A mixed clinical phenotype most common among patients. An integrated approach early makes it possible identify larger percentage subclinical myocardial dysfunction. Conclusion long period latent emphasizes need verification complications therapy expansion established paraclinical diagnostic minimum. In addition, taking account accumulated experience, recommendations are presented preparation medical documentation order ensure safety quality care.

Language: Английский

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