Ivabradine as an Adjuvant Agent for Severe Heart Failure Occurring in the Early Phase after Allogeneic Hematopoietic Cell Transplantation

Intern Med. 2022 Sep 15;61(18):2779-2784. doi: 10.2169/internalmedicine.7946-21. Epub 2022 Mar 5.

Abstract

Cardiotoxicity is a critical complication of allogeneic hematopoietic cell transplantation (allo-HCT). In particular, management of severe cardiotoxicity occurring in the early phases of allo-HCT is challenging. We encountered a case of severe cardiotoxicity resulting from AHF six days after allo-HCT, which resisted catecholamines and diuretics. The patient was treated with anthracycline-containing regimens and underwent myeloablative conditioning, including high-dose cyclophosphamide. As invasive circulatory assisting devices were contraindicated because of his immunocompromised status and bleeding tendency, we successfully treated the patient with ivabradine-containing medications. Ivabradine may therefore be considered an alternative drug for the treatment of severe cardiotoxicity induced by cytotoxic agents.

Keywords: acute heart failure; allogeneic hematopoietic cell transplantation; cardiotoxicity; ivabradine.

Publication types

  • Case Reports

MeSH terms

  • Cardiotoxicity
  • Graft vs Host Disease* / etiology
  • Heart Failure* / complications
  • Heart Failure* / therapy
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Ivabradine / therapeutic use
  • Transplantation Conditioning / methods
  • Transplantation, Homologous / adverse effects

Substances

  • Ivabradine