Qasem Abdulraheem, Bin Abdulhak Aref A, Aly Abdelrahman, Moormeier Jill
1Department of Medicine, School of Medicine, University of Missouri-Kansas City, Kansas City, MO; and 2Richard and Annette Bloch Cancer Center, Truman Medical Center-Hospital Hill, Kansas City, MO.
Am J Ther. 2016 Sep-Oct;23(5):e1188-92. doi: 10.1097/MJT.0000000000000134.
Capecitabine is an orally administered chemotherapeutic agent that is metabolized at the tumor site to 5-fluorouracil and thought to be without significant cardiac toxicity. We report a rare case of takotsubo cardiomyopathy that is thought to be related to capecitabine where the patient presented with chest pain, and ST elevation within 48 hours of capecitabine therapy. Workup included cardiac catheterization and coronary angiogram that showed nonobstructive coronary artery disease and anteroapical left ventricular wall motion abnormality with left ventricular ejection fraction of 35%. The drug was stopped, and the patient was treated with beta-blocker and angiotensin-converting enzymes inhibitor. Six weeks later, she had a repeat echocardiogram that was normal. Capecitabine-related cardiomyopathy seems to be very rare because only 5 cases have been reported in the literature (including our case). The condition has to be anticipated and treated to prevent the serious consequence of cardiac dysfunction. All reported cases have eventually recovered after stopping capecitabine.
卡培他滨是一种口服化疗药物，在肿瘤部位代谢为5-氟尿嘧啶，一般认为无明显心脏毒性。我们报告了一例罕见的应激性心肌病病例，认为与卡培他滨有关，该患者在接受卡培他滨治疗后48小时内出现胸痛和ST段抬高。检查包括心脏导管插入术和冠状动脉造影，结果显示冠状动脉无阻塞性病变，左心室前尖壁运动异常，左心室射血分数为35%。停用该药物后，患者接受了β受体阻滞剂和血管紧张素转换酶抑制剂治疗。六周后，她再次进行超声心动图检查，结果正常。卡培他滨相关的心肌病似乎非常罕见，因为文献中仅报道了5例（包括我们的病例）。必须对此情况加以预判并进行治疗，以防止心脏功能障碍的严重后果。所有报告的病例在停用卡培他滨后最终均已康复。
