Department of Cardiovascular Disease, Cleveland Clinic, Cleveland, Ohio, USA.
Am J Cardiol. 2010 Feb 15;105(4):522-6. doi: 10.1016/j.amjcard.2009.10.024.
Adriamycin is a chemotherapeutic agent that can cause severe cardiotoxicity, which potentially carries a poorer long-term prognosis than other forms of cardiomyopathy. Cardiac resynchronization therapy (CRT) has been shown to improve quality of life, exercise capacity, left ventricular ejection fraction, and survival in selected patients with heart failure. It is unclear if patients with Adriamycin-induced cardiomyopathy (AIC) respond to CRT. We reviewed clinical and echocardiographic data on 18 consecutive patients with AIC who underwent implantation of a CRT device at the Cleveland Clinic from February 2000 to April 2007. Changes in clinical and echocardiographic parameters were compared to 189 consecutive patients with other forms of nonischemic cardiomyopathy (NIC) using similar end points. Patients with AIC demonstrated significant improvements in ejection fraction, left ventricular end-diastolic and end-systolic diameters, mitral regurgitation, and New York Heart Association functional class with CRT. These changes were similar to patients in the NIC cohort. In conclusion, patients with AIC may derive a significant echocardiographic and symptomatic benefit from CRT, which is similar to that seen in other forms of NIC.
阿霉素是一种化疗药物，可导致严重的心脏毒性，其长期预后比其他形式的心肌病更差。心脏再同步治疗（CRT）已被证明可改善心力衰竭患者的生活质量、运动能力、左心室射血分数和存活率。阿霉素诱导性心肌病（AIC）患者对 CRT 的反应尚不清楚。我们回顾了 2000 年 2 月至 2007 年 4 月在克利夫兰诊所接受 CRT 设备植入的 18 例连续 AIC 患者的临床和超声心动图数据，并将这些数据与 189 例连续其他形式的非缺血性心肌病（NIC）患者进行了比较，使用类似的终点。AIC 患者的射血分数、左心室舒张末期和收缩末期直径、二尖瓣反流和纽约心脏协会功能分级在 CRT 后均有显著改善。这些变化与 NIC 队列中的患者相似。总之，AIC 患者可能从 CRT 中获得显著的超声心动图和症状获益，与其他形式的 NIC 相似。
