Lupi Alessandro, Ariotti Sara, De Pace Doranna, Ferrari Irene, Bertuol Stefano, Monti Lorenzo, Guasti Luigina, Gaudio Giovanni Vincenzo, Campana Carlo
Department of Cardiology, ASL14 Verbano-Cusio-Ossola, Ospedale Castelli, Verbania, Italy.
Radiology and Cardiology Department, Humanitas Research Hospital, Rozzano (MI), Italy.
Clin Med Insights Cardiol. 2021 Apr 13;15:11795468211010706. doi: 10.1177/11795468211010706. eCollection 2021.
Experience with angiotensin-receptor neprilysin inhibitors (ARNI) in oncologic patients with heart failure (HF) is limited. We report a case of ARNI started as first-choice therapy in a patient with relapsing hairy cell leukaemia (HCL) and HF with depressed left ventricular ejection fraction (LVEF). A middle-aged male, previously treated with rituximab for HCL, was scheduled for cardiologic screening before starting a new antineoplastic therapy for cancer relapse. The patient had symptomatic HF with reduced LVEF and high NT-proBNP levels. In this patient, early ARNI treatment was well tolerated and produced a rapid and durable improvement of symptoms, LVEF and NT-proBNP levels. Consequently, the oncologic team could start an experimental treatment with obinutuzumab, with complete HCL remission. In conclusion, in this patient with HCL and HF, ARNI therapy was safe and effective, contributing to undelayed cancer treatment.
血管紧张素受体脑啡肽酶抑制剂（ARNI）在合并心力衰竭（HF）的肿瘤患者中的应用经验有限。我们报告了一例将ARNI作为一线治疗药物用于复发性毛细胞白血病（HCL）合并左心室射血分数（LVEF）降低的心力衰竭患者的病例。一名中年男性，之前接受过利妥昔单抗治疗HCL，在开始新的抗癌复发性治疗前接受心脏筛查。该患者有症状性心力衰竭，LVEF降低，NT-proBNP水平升高。在该患者中，早期ARNI治疗耐受性良好，症状、LVEF和NT-proBNP水平迅速且持久改善。因此，肿瘤治疗团队能够开始使用奥妥珠单抗进行实验性治疗，HCL完全缓解。总之，在该HCL合并HF患者中，ARNI治疗安全有效，有助于癌症治疗不延迟。
