Increased Need for Right Ventricular Support in Patients With Chemotherapy-Induced Cardiomyopathy Undergoing Mechanical Circulatory Support

Oliveira, Guilherme H.; Dupont, Matthias; Naftel, David C.; Myers, Susan; Yuan, Ya; Tang, W.H. Wilson; González-Stawinski, Gonzalo V.; Young, James B.; Taylor, David O.; Starling, Randall C.

doi:10.1016/j.jacc.2013.09.040

Cited by 104 publications

(92 citation statements)

References 20 publications

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“…However, cardiac transplantation is not universal and mainly contra-indicated in some cohorts of RCM patients such as amyloid-induced RCM, and suffers the disadvantage of donor shortage, high infection rates and malignancies [107,108]. Besides cardiac transplantation, device therapy such as LV assist devices and mechanical circulatory support have been indicated for RCM patients [111,112]. Device therapy have comparable survival rates with cardiac transplantation [111], and has no differences on survival rates compared to HCM and DCM phenotypes.…”

Section: Discussionmentioning

confidence: 99%

“…Besides cardiac transplantation, device therapy such as LV assist devices and mechanical circulatory support have been indicated for RCM patients [111,112]. Device therapy have comparable survival rates with cardiac transplantation [111], and has no differences on survival rates compared to HCM and DCM phenotypes. The main indication of continuous axial flow LV assist devices is RCM patients with end-stage heart failure [112].…”

Section: Discussionmentioning

confidence: 99%

“…After screening, titles, abstracts and full article against the inclusion criteria, eight (8) studies were included [105][106][107][108][109][110][111][112] published between 2002 and 2016. In total, the eight studies recruited 87,410 patients.…”

Section: Study Characteristics and Outcomesmentioning

confidence: 99%

“…The main clinical endpoints assessed were elevated pulmonary vascular resistance [105], length of hospital stay [106], survival rates [105,111], mortality rates [105], and post-transplant survival rates [108][109][110]. A majority of the studies investigated long-term outcomes of surgical procedures particularly cardiac transplantation (CTx) [105][106][107][108][109][110] and mechanical circulatory support, and right or left ventricular assist device [111,112]. Cardiac transplantation has been demonstrated to have beneficial effect on 1-5 year survival rates of 40-89.5% on patients with RCM.…”

Section: Study Characteristics and Outcomesmentioning

confidence: 99%

“…Cardiac transplantation has been demonstrated to have beneficial effect on 1-5 year survival rates of 40-89.5% on patients with RCM. However, patients with RCM due to radiation [106,108,111] or amyloidosis [107,109] have poorer outcomes suggesting the need to consider genetic or idiopathic RCM for cardiac transplantation due to shortages and long wait times for donors. However, patient selection and aggressive therapies to reduce amyloid depositions on myocardial tissues suggest improvement of short-term (380 days) survival rates [110].…”

Section: Study Characteristics and Outcomesmentioning

confidence: 99%

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Restrictive cardiomyopathy: A review of literature on clinical status and meta-analysis of diagnosis and clinical management

Albakri¹

2018

Pediatr Dimensions

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Restrictive cardiomyopathy is a myocardial disorder characterized by restrictive ventricular filling. It represents one of the three phenotypes originally classified by the World Health Organization besides dilated and hypertrophic cardiomyopathies. Of the three, it is the least common phenotype but has an ominous prognosis with the highest recorded rates of sudden cardiac death. Clinical trials investigating RCM have had varied findings. This is attributable to the current classification systems of cardiomyopathy based on morphological and structural alterations rather than etiologic-based. The classification has created etiological heterogeneity requiring a combination of methods for a confirmatory diagnosis as well as complicating clinical management methods, which lacks standardized guidelines and largely relies on the standard heart failure therapy. Thus, the present review discussed current research evidence to produce a comprehensive understanding of the clinical status of RCM, including its diagnosis and clinical management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristics and Outcomesmentioning

confidence: 99%

Section: Study Characteristics and Outcomesmentioning

confidence: 99%

Section: Study Characteristics and Outcomesmentioning

confidence: 99%

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Restrictive cardiomyopathy: A review of literature on clinical status and meta-analysis of diagnosis and clinical management

Albakri¹

2018

Pediatr Dimensions

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LVADClinic: Outpatient Monitoring and Causes for Readmission

Sweitzer,

Airhart

2023

Textbook of Transplantation and Mechanical Support for End‐Stage Heart and Lung Disease

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The influence of chemotherapy on the right ventricle: did we forget something?

Tadić

Cuspidi

Hering

et al. 2017

Clinical Cardiology

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Background A large number of chemotherapy‐induced cardiovascular complications were discovered in studies over the last several decades. The focus of the majority of these studies was left ventricular (LV) remodeling. The aim of this article was to provide a comprehensive overview of potential mechanisms of chemotherapy‐induced right ventricular (RV) remodeling and summarize clinical studies on this topic. Hypothesis Chemotherapy induces RV structural, functional, and mechanical changes. Methods We searched PubMed, MEDLINE, Ovid and Embase databases for studies published from January 1990 up to September 2016 in the English language using the following keyword “chemotherapy,” “heart,” “right ventricle,” “anthracyclines,” and “trastuzumab.” Results The existing research show that RV remodeling occurs simultaneously with LV remodeling, which is why RV remodeling should not be neglected in the overall cardiac assessment of patients treated with chemotherapy, and especially those protocols that involve anthracyclines and trastuzumab. Investigations showed that these agents could significantly impact RV structure, function, and mechanics. These medications induce fibrosis of the RV myocardium, RV dilatation, decline in RV systolic function, worsening of its diastolic function, and finally impairment of RV mechanics (strain). The mechanisms of chemotherapy‐induced RV remodeling are still not entirely clear, but it is considered that direct destructive influence of chemotherapy on myocardium, oxidative stress, endothelial dysfunction, and negative impact on pulmonary circulation could significantly contribute to RV impairment. Conclusions Chemotherapy induces the impairment of RV structure, function, and mechanics by different complex mechanisms.

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Increased Need for Right Ventricular Support in Patients With Chemotherapy-Induced Cardiomyopathy Undergoing Mechanical Circulatory Support

Abstract: CCMP patients treated with MCS have survival similar to other MCS patients despite more frequent need for right ventricular assist device support and increased bleeding risk.

Cited by 104 publications

References 20 publications

Restrictive cardiomyopathy: A review of literature on clinical status and meta-analysis of diagnosis and clinical management

Restrictive cardiomyopathy: A review of literature on clinical status and meta-analysis of diagnosis and clinical management

LVADClinic: Outpatient Monitoring and Causes for Readmission

The influence of chemotherapy on the right ventricle: did we forget something?

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