Subject(s)
Blood Coagulation , Cardiac Resynchronization Therapy , Heart Failure, Systolic/therapy , Inflammation Mediators/blood , Ventricular Remodeling , Aged , Biomarkers/blood , C-Reactive Protein/metabolism , Cardiac Resynchronization Therapy/adverse effects , Case-Control Studies , Collagen Type I/blood , Female , Heart Failure, Systolic/blood , Heart Failure, Systolic/immunology , Heart Failure, Systolic/physiopathology , Humans , Male , Matrix Metalloproteinase 1/blood , Matrix Metalloproteinase 2/blood , Middle Aged , Peptide Fragments/blood , Peptides/blood , Pilot Projects , Predictive Value of Tests , Prothrombin , Spain , Tissue Inhibitor of Metalloproteinase-1/blood , Treatment OutcomeABSTRACT
Pulmonary toxicity is an infrequent but serious adverse event in patients treated with amiodarone. The main problem at present is that we lack the necessary tools to detect this event or predict which patients will develop pulmonary toxicity. Serum Krebs von den Lungen-6 (KL-6) has been previously recognized as a marker for the activity of diffuse interstitial lung disease. We describe a patient with pulmonary toxicity due to amiodarone with increased blood levels of this new marker, and discuss the clinical usefulness of this new diagnostic tool.
Subject(s)
Amiodarone/adverse effects , Antigens/blood , Glycoproteins/blood , Lung Diseases/chemically induced , Lung Diseases/diagnosis , Aged , Antigens, Neoplasm , Female , Humans , Lung Diseases/blood , Mucin-1 , MucinsABSTRACT
La toxicidad pulmonar por amiodarona es un efecto secundario infrecuente pero que puede ser fatal en los pacientes tratados con este fármaco. En la actualidad, el principal problema es que no disponemos de la herramienta necesaria para predecir o detectar qué pacientes la van a desarrollar. El KL-6 sérico ha sido reconocido como un marcador de actividad de enfermedad intersticial pulmonar difusa. Presentamos el caso de una paciente que desarrolló toxicidad pulmonar por amiodarona con niveles elevados de este nuevo marcador. Se discute la utilidad clínica de esta nueva herramienta diagnóstica
Pulmonary toxicity is an in frequent but serious adverseevent in patients treated with amiodar one. The main problemat present is that we lack the necessary tools to detect this event or predict which patients will develop pulmonary toxicity. Serum Krebs von den Lungen-6 (KL-6)has been previously recognized as a marker for the activity of diffuse interstitial lung disease. We describe a patient with pulmonary toxicity due to amiodar one with increased blood levels of this new marker, and discuss the clinical usefulness of this new diagnostic tool
Subject(s)
Female , Humans , Amiodarone/toxicity , Anti-Arrhythmia Agents , Arrhythmias, Cardiac/drug therapy , Lung , GlycoproteinsABSTRACT
Heart failure is one of the most prevalent diseases in industrialized countries. Although the prognosis of patients with heart failure is still poor, in recent decades new therapies have been investigated in order to improve quality of life and survival. However, up to 30% of the patients with advanced heart failure present disturbances in intraventricular conduction, and this produces asynchrony of ventricular contractility, leading to further deterioration in heart function. Cardiac resynchronization therapy can improve the synchrony of ventricular contractility. Numerous studies have demonstrated the benefits of biventricular stimulation therapy for improving hemodynamic parameters, quality of life, 6-minute walking test performance and functional class in patients with heart failure, ventricular systolic dysfunction and disturbances in intraventricular conduction. Some studies have demonstrated longer survival times in patients treated with cardiac resynchronization plus a defibrillator. Nonetheless, many questions about the benefits of heart resynchronization therapy, site of stimulation and best type of device (pacemaker or defibrillator) remain unresolved.
