Remission of chronic anthracycline-induced heart failure with support from a continuous-flow left ventricular assist device

Tex Heart Inst J. 2012;39(4):554-6.

Abstract

We report the case of a patient who had chronic anthracycline-induced cardiomyopathy that was reversed after treatment with a left ventricular assist device. A 29-year-old woman had undergone anthracycline-based chemotherapy as a teenager in 1991 and 1992 and received a diagnosis of dilated cardiomyopathy 10 years later. Optimal medical therapy had initially controlled the symptoms of heart failure. However, in June 2006, the symptoms worsened to New York Heart Association functional class IV status. We implanted a continuous-flow left ventricular assist device as a bridge to cardiac transplantation; of note, a left ventricular core biopsy at that time showed no replacement fibrosis. The patient's clinical status improved thereafter, enabling left ventricular assist device ex-plantation after 17 months. To our knowledge, this is the first report of the use of left ventricular assist device support to reverse chronic anthracycline-induced heart failure.

Keywords: Anthracyclines/adverse effects; cardiomyopathies/chemically induced; heart failure/chemically induced; heart-assist devices; heart/drug effects; recovery of function; treatment outcome; ventricular dysfunction, left.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anthracyclines / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Biopsy
  • Cardiomyopathy, Dilated / chemically induced
  • Cardiomyopathy, Dilated / diagnosis
  • Cardiomyopathy, Dilated / physiopathology
  • Cardiomyopathy, Dilated / therapy*
  • Chronic Disease
  • Device Removal
  • Female
  • Heart Failure / chemically induced
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Ventricles / drug effects
  • Heart Ventricles / physiopathology
  • Heart Ventricles / ultrastructure
  • Heart-Assist Devices*
  • Hodgkin Disease / drug therapy
  • Humans
  • Microscopy, Electron
  • Prosthesis Design
  • Remission Induction
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left

Substances

  • Anthracyclines
  • Antineoplastic Agents