Anthracycline-induced cardiomyopathy in the long-term period after chemotherapy: clinical case

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Abstract

Background. As is known, the treatment of the oncological process leads either to the occurrence of cardiovascular pathology, or to an increase in the risk of death from cardiovascular diseases. Currently, the concept of ˝cardiovascular toxicity˝ has been introduced, which is associated with the treatment of cancer (CTR-CVT). Systemic drug anthracycline-containing anticancer therapy can cause a number of cardiovascular complications, such as myocardial systolic dysfunction, coronary heart disease, cardiac arrhythmias, arterial hypertension. Particular attention is paid to anthracycline drugs, because they are still included in combinations of many adjuvant therapy regimens and first-line treatment of both the most common cancers and rarer ones.

Clinical Case Description. The article presents a clinical case of a patient who received adjuvant polychemotherapy for breast cancer in 2017 with AC ×4 →D ×4 regimen, in which chronic anthracycline-induced cardiomyopathy manifested years after completion of antitumor therapy. The development of anthracycline cardiomyopathy is possible even in patients with initially low cardiac risk.

Conclusion. The clinical case highlights the importance of monitoring patients after the end of anthracycline antitumor therapy, in particular, they are shown to periodically perform an echocardiographic study in order to detect delayed asymptomatic myocardial dysfunction.

About the authors

Nikita A. Kozjavin

Petrov National Medicine Research Center of Oncology

Email: kozjavin-nikita@mail.ru
ORCID iD: 0000-0003-2759-4817

department head

Russian Federation, 191015, St. Petersburg, Kirochnaya Str., 41

Ekaterina A. Mureyko

Petrov National Medicine Research Center of Oncology

Email: emureyko@mail.ru
ORCID iD: 0000-0003-1626-082X
SPIN-code: 2023-1598

resident oncologist

Russian Federation, 191015, St. Petersburg, Kirochnaya Str., 41

Viktor S. Nikiforov

Mechnikov North-Western State Medical University

Email: victor-nikiforov@yandex.ru
ORCID iD: 0000-0001-7862-0937
SPIN-code: 4652-0981

MD, D. Sci. (Med.), Prof., dean

Russian Federation, 41, Kirochnaya Str., St. Petersburg, 191015

Alexey M. Beljaev

Petrov National Medicine Research Center of Oncology

Author for correspondence.
Email: bam281060@yandex.ru
ORCID iD: 0000-0001-6588-1257
SPIN-code: 9445-9473

MD, D. Sci. (Med.), Prof., director, 

Russian Federation, 191015, St. Petersburg, Kirochnaya Str., 41

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Supplementary files

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2. Fig. 1. Echocardiography of patient D.N. Apical ٤-chamber section (significant reduction in Simpson's ejection fraction).

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3. Fig. 2. Echocardiography of patient D.N. Apical 4-chamber section (severe mitral regurgitation).

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4. Fig. 3. Echocardiography of patient D.N. 3 months after the start of treatment. Apical 4-chamber section (normalization of ejection fraction according to Simpson).

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