Kozáková M, Beńesová E, Cieslar P, Sálková J
Cas Lek Cesk. 1989 Jan 20;128(4):105-9.
After cytostatic treatment severe arrhythmias, the development of angina pectoris and even the development of acute myocardial infarction and sudden death were observed. Therefore we made in 42 patients with malignant haematological disease treated with cytostatics 96 Holter monitorings of the electrocardiographic signal. The monitoring was made during the administration of cytostatics as well as during the time interval between the administration of combinations of cytostatics. In both instances (during the administration and during the interval between administration) we recorded a surprisingly high, mean all-day as well as maximal, heart rate. In the group monitored during administration of chemotherapeutic drugs we observed 5-8 hours after administration of cytostatics serious ventricular arrhythmias [incl. ventricular tachycardia], denivelization of the ST segment, paroxysms of supraventricular tachycardia. In the group monitored during the interval between administration of cytostatics the sick-sinus syndrome was recorded, as well as a passive nodal rhythm, disorders of the intraventricular conduction. The described changes are explained by the release of vasoactive substances after administration of cytostatics, by a change of the transmembrane calcium transport leading to an increased excitability of the heart muscle and possibly to coronary spasms and direct irreversible damage of the conduction system.
在进行细胞抑制治疗后，观察到严重心律失常、心绞痛的发生，甚至急性心肌梗死和猝死的发生。因此，我们对42例接受细胞抑制剂治疗的恶性血液病患者进行了96次心电图信号的动态心电图监测。监测在给予细胞抑制剂期间以及细胞抑制剂联合给药的时间间隔内进行。在这两种情况下（给药期间和给药间隔期间），我们记录到全天平均心率以及最大心率都出奇地高。在化疗药物给药期间进行监测的组中，我们在给予细胞抑制剂后5 - 8小时观察到严重的室性心律失常[包括室性心动过速]、ST段压低、室上性心动过速发作。在细胞抑制剂给药间隔期间进行监测的组中，记录到病态窦房结综合征以及被动性结性心律、室内传导障碍。所述变化可通过细胞抑制剂给药后血管活性物质的释放、跨膜钙转运的改变导致心肌兴奋性增加以及可能导致冠状动脉痉挛和传导系统的直接不可逆损伤来解释。
