Key result
Bevacizumab chemotherapy is linked to fatal CHF driven by diffuse myocardial fibrosis matching CMR LGE.
Case Report (n=1)
This case report provides direct histopathological correlation for CMR late gadolinium enhancement findings in bevacizumab-related cardiomyopathy, demonstrating diffuse interstitial fibrosis and edema.
May warrant cardiac monitoring with bevacizumab; leaves open prospective validation of LGE-CMR for fibrosis detection.
We report an autopsy case of a 69-year-old female with cervical cancer. She was given bevacizumab-containing chemotherapy for 4 months. After two years of chemotherapy, she developed congestive heart failure (CHF) with left ventricular dysfunction. Cardiac magnetic resonance (CMR) imaging revealed late gadolinium enhancement (LGE) of linear mid-wall delayed enhancement located in the basal to the mid-septal wall, suggesting bevacizumab-related cardiotoxicity. Although she was treated with cardioprotective medications and discharged, she eventually died from worsening CHF a year later, and we conducted an autopsy. Histopathological examination revealed diffuse fibrosis in the myocardium, and the area where LGE was present on CMR showed thinning and wavy changes in cardiomyocytes with diffuse interstitial fibrosis and edema.
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Hashimoto et al. (2022) conducted a case report in Bevacizumab-related cardiomyopathy (n=1). Bevacizumab was evaluated. Bevacizumab-containing chemotherapy was associated with fatal congestive heart failure, with autopsy revealing diffuse myocardial fibrosis corresponding to late gadolinium enhancement on cardiac MRI.
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