贝伐珠单抗致肺腺癌患者心律失常：病例报告。
Bevacizumab-induced arrhythmia in a patient with lung adenocarcinoma: A case report.
机构信息
Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Medicine (Baltimore). 2023 Sep 1;102(35):e34799. doi: 10.1097/MD.0000000000034799.
RATIONALE
Cardiotoxicity is an important side effect of vascular endothelial growth factor inhibitors therapy in the treatment of cancer. Massive studies have shown bevacizumab-related hypertension, venous, and arterial thrombosis.
PATIENT CONCERNS
A 56-year-old female patient was treated with bevacizumab monotherapy for lung adenocarcinoma. The patient was detected a poor R-wave increase with slight ST segment elevation in V1-V3 leads, and ventricular arrhythmia.
DIAGNOSIS
The incidental arrhythmia caused by bevacizumab was considered.
INTERVENTIONS
The patients received aspirin and amiodarone (0.2 g tid) to treat arrhythmia. After consultation with the cardiology department, the patient received a diagnostic coronary angiography. Coronary angiography showed 30% of the right coronary artery stenoses and no obvious organic stenosis in the left main artery, left anterior ascending, or left circumflex.
OUTCOMES
The patient exhibited disappearance of chest tightness and rapid heartbeat after the treatment of amiodarone. Electrocardiogram monitoring results returning to normal.
LESSONS
This is the first reported case of bevacizumab-associated arrhythmia. It is advisable to consider the risk of arrhythmia in bevacizumab monotherapy or combines treatment.
背景
血管内皮生长因子抑制剂在癌症治疗中具有重要的抗血管生成作用，但可引起心脏毒性。大量研究显示贝伐珠单抗可引起高血压、静脉血栓和动脉血栓形成。
病例介绍
一位 56 岁女性患者因肺腺癌接受贝伐珠单抗单药治疗。该患者在 V1-V3 导联中出现 R 波振幅降低伴轻度 ST 段抬高，同时伴有室性心律失常。
诊断
考虑为贝伐珠单抗引起的偶发性心律失常。
干预措施
给予患者阿司匹林和胺碘酮（0.2g，每日 3 次）治疗心律失常。心内科会诊后，为患者进行了诊断性冠状动脉造影。冠状动脉造影显示右冠状动脉狭窄 30%，左主干、左前降支和左旋支无明显器质性狭窄。
结果
胺碘酮治疗后，患者胸痛和快速性心跳症状消失，心电图监测结果恢复正常。
结论
这是首例贝伐珠单抗相关性心律失常的报道。在贝伐珠单抗单药或联合治疗时，应考虑发生心律失常的风险。
Zotero 插件