Department of Geriatric Hematology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
J Geriatr Cardiol. 2012 Dec;9(4):411-4. doi: 10.3724/SP.J.1263.2012.05251.
Because it is safe and well tolerated, imatinib is a standard first-line therapy for chronic myeloid leukemia (CML). Although there have been sporadic reports of imatinib-induced cardiotoxicity, including left ventricle (LV) dysfunction and heart failure, the evidence for it is contradictory. Here, we reported a case of an 88-year-old male patient with CML developed decompensated heart failure following imatinib therapy. Four days after the initiation of imatinib, the patient developed orthopnea, edema and a pleural effusion accompanied by abdominal distension, nausea and vomiting. The chest X-ray film showed an enlarged cardiac profile. The echocardiogram demonstrated a decreased LV ejection fraction and enlarged left-side cardiac chambers. B-type natriuretic peptide concentrations were markedly increased. The patient recovered soon after the withdrawal of imatinib and introduction of comprehensive therapy for heart failure. Imatinib-induced cardiotoxicity in elderly patients is a potentially serious complication that merits further evaluation.
由于伊马替尼安全且耐受良好，因此是慢性髓性白血病（CML）的标准一线治疗药物。尽管有散在的伊马替尼引起的心脏毒性报告，包括左心室（LV）功能障碍和心力衰竭，但证据相互矛盾。在这里，我们报告了一例 88 岁男性 CML 患者在接受伊马替尼治疗后发生心力衰竭失代偿。在开始使用伊马替尼后 4 天，患者出现端坐呼吸、水肿和胸腔积液，同时伴有腹胀、恶心和呕吐。胸部 X 光片显示心脏轮廓增大。超声心动图显示左心室射血分数降低，左侧心腔增大。B 型利钠肽浓度明显升高。停止使用伊马替尼并采用心力衰竭综合治疗后，患者很快康复。伊马替尼引起的老年患者心脏毒性是一种潜在的严重并发症，值得进一步评估。
