The Variations in the Immunologic Features and Interleukin-6 Levels for the Surgical Treatment of Cardiac Myxomas

Yokomuro, Hiroki; Watanabe, Yozo; Shiono, Noritsugu; Koyama, Nobuya; Takanashi, Yoshinori

doi:10.1007/s00595-006-3448-6

Cited by 35 publications

(20 citation statements)

References 19 publications

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“…Cardiac arrhythmias, atrial fibrillation, and atrial flutter reportedly occur in approximately 20% of patients with cardiac myxoma. 16,19 In our series, 69% of patients presented with arrhythmia or palpitation. Embolic phenomena are reported in approximately 35% of left-sided and 10% of right-sided myxomas.…”

Section: Discussionmentioning

confidence: 59%

Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Rahman¹,

Ali²,

Kabir³

et al. 2016

Bangladesh Heart J

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Introduction: Cardiac myxoma is a benign neoplasm that represents the most common primary tumour of the heart. Because of nonspecific symptoms, early diagnosis may be a challenge. Although the left atrium is the most commonly involved site of origin in 75% of cases, it can arise from any of the cardiac chambers. Symptoms from a cardiac myxoma are more pronounced when the myxomas are left-sided, racemosus, and over 5 cm in diameter. Symptoms are produced by mechanical interference with cardiac function or embolization. Being intravascular and friable, myxomas account for most cases of tumor embolism. The site of embolism is dependent upon the location (left or right atrium) and the presence of an intracardiac shunt. Most atrial myxomas are benign and can be removed by surgical resection.Objectives: To see clinical presentation and echocardiographic profile of cardiac myoxomas.Methods: 90 cardiac myxoma patients who admitted both in cardiology and cardiac surgery departments of National Institute of Cardiovascular Diseases (NICVD), Dhaka from August 2003 to July, 2014 were studied clinically and by echocardiogram. Clinical histories were reviewed, noting age, gender, and clinical presentation.Results: There were 30 males and 60 females, ages ranged from 17 to 76 years. The commonest clinical feature was dyspnoea (94.44%), followed by palpitation (76.67%), chest discomfort (74.44%), constitutional symptoms (50%), pedal oedema (20%), syncope (14.44%), and embolization (7.7%). The mean duration of symptoms was 09.7 months.Conclusion: The clinical presentation of cardiac myxoma is often nonspecific, so high index of clinical suspicion is important for its early and correct diagnosis. The size and appearance of the myxomas correlated with the presenting symptoms.Bangladesh Heart Journal 2016; 31(1) : 18-22

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Section: Discussionmentioning

confidence: 59%

Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Rahman¹,

Ali²,

Kabir³

et al. 2016

Bangladesh Heart J

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“…The constitutional symptoms and signs are fever, fatigue, weakness, weight loss, anemia, arthralgia, and myalgia. Some investigations have revealed that it is associated with an immunologic basis, especially with high values of interleukin-6 in plasma [19-21] . In addition, unknown factors may also affect this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas

Yüksel¹,

Saba²,

Velioğlu³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveWe aimed to present clinical features, surgical approaches, importance of surgical technique and long-term outcomes of our patients with cardiac myxoma who underwent surgery.MethodsWe retrospectively collected data of patients with cardiac myxoma who underwent surgical resection between February 1990 and November 2014. Biatrial approach is the preferred surgical method in a large proportion of patients that are operated due to left atrial myxoma because it provides wider exposure than the uniatrial approach. To prevent recurrence during surgical resection, a large excision is made so as to include at least 5 mm of normal area from clean tissue around the tumor. Moreover, special attention is paid to the excision that is made as a whole, without digesting the fragment of tumor with gentle dissections.ResultsForty-three patients (20 males, mean age of 51.7±8.8 years) were included. Most common symptom was dyspnea (48.8%). Tumor was located in the left atrium in 37 (86%) patients. Resections were achieved via biatrial approach in 34 patients, uniatrial approach in 8 patients, and right atriotomy with right ventriculotomy in 1 patient. One patient died due to low cardiac output syndrome in the early postoperative period. Mean follow-up time was 102.3±66.5 months. Actuarial survival rates were 95%, 92% and 78% at five, 10 and 15 years, respectively. Recurrence was observed in none of the patients during follow-up.ConclusionAlthough myxomas are benign tumors, due to embolic complications and obstructive signs, they should be treated surgically as soon as possible after diagnosis. To prevent recurrence, especially in cardiac myxomas which are located in left atrium, preferred biatrial approach is suggested for wide resection of the tumor and to avoid residual tumor.

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“…Non-specific constitutional symptoms such as fever, lethargy, physical weakness, fatigue, anorexia, painful erythema, loss of weight and appetite, are seen in up to 90% of cases due to autocrine cytokine production such as IL-6 and IL-8 [8,36]. Non-specific laboratory findings such as chronic hemolytic anemia and thrombocytopenia (due to cellular destruction caused by abnormal blood flow across the tumor surface), polycythemia, erythrocytosis and leukocytosis, raised erythrocyte sedimentation rate, serum C -reactive proteins and immunoglobulins may also be seen in some CM [37,38].…”

Section: Cardiac Myxomasmentioning

confidence: 99%

“…Increased expression of MUC1, IL6 and α1-globulin in CM is associated with increased risk of embolization [36,101]. Recently plakophilin-2 has been identified as adherens junction protein in CM [104].…”

Section: Molecular Genetics Of Cardiac Myxomasmentioning

confidence: 99%

Molecular Basis of Cardiac Myxomas

Singhal

Luk

Rao

et al. 2014

IJMS

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Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

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The Variations in the Immunologic Features and Interleukin-6 Levels for the Surgical Treatment of Cardiac Myxomas

Cited by 35 publications

References 19 publications

Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas

Molecular Basis of Cardiac Myxomas

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The Variations in the Immunologic Features and Interleukin-6 Levels for the Surgical Treatment of Cardiac Myxomas

Cited by 35 publications

References 19 publications

Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas

Molecular Basis of Cardiac Myxomas

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Clinical profile of cardiac myxoma: 11 years experience of 90 cases

Clinical profile of cardiac myxoma: 11 years experience of 90 cases