title: Remission of chronic anthracycline-induced heart failure with support from a continuous-flow left ventricular assist device.
abstract: We report the case of a patient who had chronic anthracycline-induced cardiomyopathy that was reversed after treatment with a left ventricular assist device. A 29-year-old woman had undergone anthracycline-based chemotherapy as a teenager in 1991 and 1992 and received a diagnosis of dilated cardiomyopathy 10 years later. Optimal medical therapy had initially controlled the symptoms of heart failure. However, in June 2006, the symptoms worsened to New York Heart Association functional class IV status. We implanted a continuous-flow left ventricular assist device as a bridge to cardiac transplantation; of note, a left ventricular core biopsy at that time showed no replacement fibrosis. The patient's clinical status improved thereafter, enabling left ventricular assist device ex-plantation after 17 months. To our knowledge, this is the first report of the use of left ventricular assist device support to reverse chronic anthracycline-induced heart failure.
authors.affiliation: Center for Cardiac Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Khan
authors.forename: Syed Arman
authors.initials: SA
authors.lastname: Husain
authors.forename: Syed Iman
authors.initials: SI
authors.lastname: Husain
authors.forename: Natalia
authors.initials: N
authors.lastname: Khalaf
authors.forename: Joggy
authors.initials: J
authors.lastname: George
authors.forename: Farshad
authors.initials: F
authors.lastname: Raissi
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Segura
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: Roberta C
authors.initials: RC
authors.lastname: Bogaev
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002908:Chronic Disease; D020878:Device Removal; D005260:Female; D006333:Heart Failure / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology / Q000648:ultrastructure; D006353:Heart-Assist Devices; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D008854:Microscopy, Electron; D011474:Prosthesis Design; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents