Najafian Jamshid, Nasri Ali, Etemadifar Masoud, Salehzadeh Fardin
Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2019 Dec 10;10:211. doi: 10.4103/ijpvm.IJPVM_477_17. eCollection 2019.
Mitoxantrone (MTX) is an antracyclin drug that is used for treatment of patients with chronic refractory multiple sclerosis (MS). Congestive heart failure (CHF) is a rare complication of this drug that may occur early, during therapy, or late, months or years after termination of therapy.
The aim of this study is to evaluate the long-term adverse effect of MTX on cardiac function.
The study involved 49 MS patients on MTX therapy because of their disease was refractory to other treatments (18 men and 31 women). They were treated in two canters related to Esfahan University of Medical Sciences. The mean age was 34.65 ± 9.56 years. Systolic and diastolic left ventricular (LV) functions were measured by echocardiography. The baseline echocardiographic data were collected from patients' file. Echocardiography was repeated by a single cardiologist in 2016.
After MTX therapy, one patient's ejection fraction (EF) reduced below 50% (2%). In spite of their normal diastolic function before therapy, two patients developed diastolic dysfunction (4%). Nonparametric binominal analysis reveals that MTX therapy increased the probability of developing systolic dysfunction, early or late < 001.
MS patients treated with MTX are at increased risk of developing early and late-LV dysfunction, so all patients on MTX therapy must be periodically evaluated for these late complications.
米托蒽醌（MTX）是一种蒽环类药物，用于治疗慢性难治性多发性硬化症（MS）患者。充血性心力衰竭（CHF）是该药物罕见的并发症，可能在治疗早期、治疗期间或晚期（治疗终止数月或数年之后）出现。
本研究旨在评估MTX对心脏功能的长期不良影响。
本研究纳入了49例因疾病对其他治疗无效而接受MTX治疗的MS患者（18例男性和31例女性）。他们在与伊斯法罕医科大学相关的两个中心接受治疗。平均年龄为34.65±9.56岁。通过超声心动图测量左心室（LV）的收缩和舒张功能。从患者病历中收集基线超声心动图数据。2016年由一名心脏病专家重复进行超声心动图检查。
MTX治疗后，1例患者的射血分数（EF）降至50%以下（2%）。尽管治疗前舒张功能正常，但2例患者出现舒张功能障碍（4%）。非参数二项式分析显示，MTX治疗增加了早期或晚期发生收缩功能障碍的概率<0.01。
接受MTX治疗的MS患者发生早期和晚期LV功能障碍的风险增加，因此所有接受MTX治疗的患者必须定期评估这些晚期并发症。
