ABSTRACT
Anthracycline, a widely used anti-cancer agent, can elicit irreversible cardiomyopathy called anthracycline-induced cardiomyopathy (ACM). In this report, we describe 5 cases of severe chronic heart failure due to ACM effectively treated with the beta-blocker, carvedilol. Their left ventricular function as well as cardiac symptoms were persistently improved after treatment with carvedilol, suggesting that carvedilol may be an effective therapeutic strategy for ACM as demonstrated in other forms of chronic heart failure.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Anthracyclines/adverse effects , Carbazoles/therapeutic use , Cardiomyopathies/drug therapy , Heart Failure/drug therapy , Propanolamines/therapeutic use , Ventricular Dysfunction/drug therapy , Adult , Cardiomyopathies/chemically induced , Cardiomyopathies/diagnostic imaging , Carvedilol , Echocardiography , Female , Heart Failure/chemically induced , Heart Failure/diagnostic imaging , Humans , Male , Middle Aged , Treatment Outcome , Ventricular Dysfunction/chemically induced , Ventricular Dysfunction/diagnostic imaging , Ventricular Function, Left/drug effectsABSTRACT
Postprandial increase in remnant lipoprotein concentrations has been suggested as an important atherogenic factor. However, the influence of these remnants on the development of restenosis after percutaneous coronary intervention (PCI) remains to be examined. The present study was designed to address this point. In 60 consecutive patients with successful PCI, the influences of possible risk factors on the development of restenosis, including remnant-like particles (RLP) cholesterol (RLP-C) and triglyceride (RLP-TG), were examined. While mean concentrations of RLP-C and RLP-TG were normal in fasting state, postprandial change in RLP-C concentrations was a significant and independent risk factor for restenosis after PCI. The calculated cut-off index (COI) for the change was +64%. When the patients were divided into 2 groups according to this COI, minimal lumen diameter (MLD) and reference coronary diameter were comparable before and immediately after PCI between the high- (COI < 64%) and the low- (COI < 64%) responders. However, follow-up coronary angiography 3 to 6 months after PCI demonstrated that MLD, late loss, and loss index were all worse in the high responders compared with the low responders. These results indicate that post-prandial increase in RLP-C concentrations is an independent risk factor for restenosis after successful PCI, even in patients with normal fasting RLP-C levels.
