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January 1, 2015Journal of Community Hospital Internal Medicine PerspectivesOpen Access

Partially reversible bortezomib-induced cardiotoxicity: an unusual cause of acute cardiomyopathy

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Key result

Bortezomib linked to acute, partially reversible cardiotoxicity with an LVEF drop to 15%.

  • n=1

Why the study?

Proteasome inhibitors like bortezomib are not commonly associated with cardiotoxicity in patients without pre-existing cardiac dysfunction or other cardiotoxic agents, creating uncertainty about their cardiac risks.

Design

Case report

Follow-up

Hours after third bortezomib treatment

Authors

MMMarcelle MeseehaSUNY Upstate Medical UniversityVKVictor O. KoladeSUNY Upstate Medical UniversityMAMaximos N. AttiaGuthrie Foundation

Discussion

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Overview

Bortezomib may cause acute LV dysfunction in ESRD without prior heart disease; leaves open need for prospective monitoring studies.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 66-year-old woman with end-stage renal disease and IgG kappa myeloma who developed acute left ventricular dysfunction after bortezomib treatment.
E
Exposure
Bortezomib 2.5 mg subcutaneously weekly as part of CyBorD chemotherapy (with cyclophosphamide 500 mg orally weekly and dexamethasone 20-40 mg orally weekly)
O
Outcome
Acute left ventricular dysfunction (bortezomib-induced cardiotoxicity)safety

Bortezomib therapy may cause acute, partially reversible left ventricular dysfunction, highlighting the importance of baseline and serial cardiac monitoring in patients receiving proteasome inhibitors.

Limitations

  • Single case report
  • Patient had multiple comorbidities including end-stage renal disease and left bundle branch block
  • Prior exposure to other potentially cardiotoxic agents

Cite This Study

Meseeha et al. (2015) conducted a case report in IgG kappa myeloma (n=1). Bortezomib was evaluated on Development of acute left ventricular dysfunction. A 66-year-old woman with end-stage renal disease developed acute, partially reversible left ventricular dysfunction with an ejection fraction drop from 55% to 15% after her third dose of bortezomib.

synapsesocial.com/papers/6abe518cb101bbff5e78decchttps://doi.org/10.3402/jchimp.v5.28982

Topics

Heart failureHFrEF treatment
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Severe reversible cardiac failure after bortezomib treatment combined with chemotherapy in a non-small cell lung cancer patient: a case report2006 · 121 citations
  2. 2Incidence and Risk of Cardiotoxicity Associated with Bortezomib in the Treatment of Cancer: A Systematic Review and Meta-Analysis2014 · 125 citations
  3. 3Cyclophosphamide-Induced Cardiomyopathy2013 · 142 citations
  4. 4The ubiquitin-proteasome system and nonsense-mediated mRNA decay in hypertrophic cardiomyopathy2009 · 86 citations
  5. 5Mechanisms of chronic heart failure development in end-stage renal disease patients on chronic hemodialysis2009 · 52 citations