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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of a 52-year-old man with multiple myeloma and rapidly progressive heart failure who died unexpectedly from a probable arrhythmia. Postmortem examination revealed infiltrative amyloid cardiomyopathy, a rare cause of predominantly diastolic myocardial disease. Cardiac amyloidosis should be considered in any patient presenting with congestive heart failure, preserved systolic function, and a discrepancy between a low QRS voltage on electrocardiography and an apparent left ventricular hypertrophy on sonogram. The pattern of left ventricular diastolic dysfunction changes during the course of amyloidosis and the classically described restrictive physiology occurs only in advanced stages of the disease.
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PMID:Cardiac amyloidosis in a patient with multiple myeloma: a case report and review of literature. 1917 24

Cardiac amyloidosis represents a prognostically relevant comorbidity in multiple myeloma. We report the case of a patient in whom severe heart failure symptoms as a consequence of cardiac AL-amyloidosis resolved after tandem high-dose melphalan therapy followed by autologous blood-stem cell transplantation. Partial regression of cardiac amyloid deposits and improvement of cardiac function were objectified.
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PMID:[52 year-old patient with severe heart failure due to multiple myeloma]. 1918 21

Coronary heart disease and chronic heart failure are common diseases and have an increasing frequency. Although interventional and conventional drug therapy may delay ventricular remodelling, there is no basic therapeutic regime available for preventing or even reversing this process. Chronic coronary artery disease and heart failure impair quality of life and are associated with subsequent worsening of the cardiac pump function. Numerous studies carried out in the past few years have demonstrated, that the intracoronary stem cell therapy has to be considered as a safe therapeutic procedure in heart disease, when destroyed and/or compromised heart muscle must be regenerated. This kind of cell therapy with autologous bone marrow cells is completely justified ethically, except for the small numbers of patients with direct or indirect bone marrow disease (e.g. myeloma, leukemic infiltration) in whom there would be lesions of mononuclear cells. Several preclinical as well as clinical trials have shown that transplantation of autologous bone marrow cells or precursor cells improved cardiac function after myocardial infarction and in chronic coronary heart disease. The age of infarction seems to be irrelevant to regenerative potency of stem cells, since stem cells therapy in old infarctions (many years old) is almost equally effective in comparison to previous infarcts. Further indications are non-ischemic cardiomyopathy (dilatative cardiomyopathy) and heart failure due to hypertensive heart disease.
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PMID:Therapeutic potentials of stem cells in cardiac diseases. 1927 33

We present the case of a 60-year-old lady who was treated with chemotherapy for myeloma. Following initiation of bortezomib, she developed heart failure which was associated with a reduction in left ventricular systolic function. A gadolinium enhanced cardiovascular magnetic resonance scan demonstrated midwall hyperenhancement consistent with midwall fibrosis.
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PMID:Myocardial scarring following chemotherapy for multiple myeloma detected using late gadolinium hyperenhancement cardiovascular magnetic resonance. 1958 44

Amyloidosis is an uncommon disorder in which proteins change conformation, aggregate, and form fibrils that infiltrate tissues, leading to organ failure and death. The most frequent types are light-chain (AL) derived from monoclonal B-cell disorders producing amyloidogenic immunoglobulin light chains, and the hereditary and "senile systemic" (ATTR) variants from mutant and wild-type transthyretin (TTR). Diagnosis requires tissue biopsy. AL is more frequent and causes more organ disease than ATTR. Although both can cause cardiomyopathy and heart failure, AL progresses more quickly, so survival depends on timely diagnosis. Typing is usually based on clinical and laboratory findings with monoclonal gammopathy evaluation and, if indicated, TTR gene testing. Direct tissue typing is required when one patient has 2 potential amyloid-forming proteins. In coming years, widespread use of definitive proteomics will improve typing. New therapies are in testing for ATTR, whereas those for AL have followed multiple myeloma, leading to improved survival. Challenges of diagnosing and caring for patients with amyloidosis include determination of type, counseling, and delivery of prompt therapy often while managing multisystem disease. Recent advances grew from clinical research and advocacy in many countries, and global husbandry of such efforts will reap future benefits for families and patients with amyloidosis.
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PMID:How I treat amyloidosis. 1961 78

Sjogren syndrome is associated with lymphoproliferative disease in 7% of cases; however, association with AL amyloidosis is uncommon. We present a patient who presented simultaneously with Sjogren syndrome (supported by dry mouth, positive Schirmer's test, anti-Ro/SSA antibodies, and a lower lip salivary gland biopsy) and AL amyloidosis revealed by heart failure without myeloma. Although is it know that amyloidosis can masquerade as Sjogren syndrome, the occurrence of simultaneous AL amyloidosis and primary Sjogren syndrome has been reported rarely.
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PMID:Systemic light chain amyloidosis and Sjogren syndrome: an uncommon association. 1963 91

We report a case of a female with stage I infiltrating ductal carcinoma who received adjuvant therapy including trastuzumab. One year later she developed lytic lesions and was retreated with trastuzumab that was held after she developed symptomatic heart failure. Lytic lesions were attributed to relapse of breast cancer, and cardiac failure attributed to prior trastuzumab therapy. After complications necessitated multiple hospitalizations, a further workup revealed that the lytic lesions were not metastatic breast cancer but multiple myeloma. Her advanced multiple myeloma was associated with systemic amyloidosis involving gut and heart, which ultimately led to her demise. This report addresses the pitfalls of overlapping symptoms and the question of which patients with suspected metastatic disease should undergo a biopsy.
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PMID:Metastatic breast cancer or multiple myeloma? Camouflage by lytic lesions. 2022 44

Cyclophosphamide is used for liver cancer, breast cancer and multiple myeloma, and the pretreatment of hematopoietic stem cell transplantation. A medium to high dose of cyclophosphamide is known to cause irreversible heart failure in some cases, and recently cardiac tamponade and pericarditis have been reported to occur when cyclophosphamide is administered for the pretreatment of hematopoietic stem cell transplantation. To test whether cyclophosphamide itself induces cellular toxicity, we investigated a toxic effect of cyclophosphamide, acrolein, a metabolite of cyclophosphamide, and doxorubicin, which is known to have cardiac toxicity, in the H9c2 cell line and the isolated Langendorff-perfused rat hearts. Cyclophosphamide itself did not have a toxic effect, whereas the toxicity of acrolein is 1, 000 times higher than that of doxorubicin in the H9c2 cell line. Acrolein, but not cyclophosphamide, reduced the left ventricular developed pressure and heart rate, and increased the left ventricular end diastolic pressure. These results suggest that the cardiac toxicity of cyclophosphamide may be caused by acrolein, one of its metabolites. Cyclophosphamide is known to cause hemorrhagic cystitis, and uromitexan was shown not to protect against the cardiac toxicity of cyclophosphamide. Development of new cardioprotective compounds is needed to administer CPA more safely.
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PMID:[Analysis of cardiac toxicity caused by cyclophosphamide in the H9c2 cell line and isolated and perfused rat hearts]. 2041 25

Hemodialysis was born in 1945 to treat acute renal failure, and it has progressively become a rescue therapy for patients with chronic kidney disease (CKD) stage 5, otherwise doomed to death. During the years, technological innovations have led to improved dialytic tolerance, making possible to extend the treatment to a greater number of subjects. Low- and high-flux bicarbonate dialysis are nowadays the most frequent hemodialysis techniques; hemodiafiltration with different modalities, short daily and overnight hemo-dialysis are also widespread, each of them with peculiar characteristics. A recent randomized controlled clinical trial has identified high-flux hemodialysis as the best treatment for patients with low serum levels of albumin and for diabetics in comparison to low flux dialysis. Apart from the treatment of end-stage renal disease (ESRD), hemodialysis has new and important applications, including heart failure treatment and multiple myeloma. The need to provide hemodialysis patients a better quality of life has increased the interest in developing new techniques, such as the wearable artificial kidney, although still in initial clinical development. During the last 60 years, we have seen an exciting evolution in the field of hemodialysis, which has led to important changes in the outcome of ESRD patients. The preclinical and clinical hard work ongoing in earlier stages of CKD should be able to obtain further relevant improvements and maybe avoid the need of hemodialysis itself.
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PMID:Hemodialysis: yesterday, today and tomorrow. 2042 66

We describe a 42-year-old multiparous woman who was admitted to our hospital in the 28 th week of her twin pregnancy because of anaemia and proteinuria. She was subsequently diagnosed with multiple myeloma. An uncomplicated elective caesarean section was performed at 35 weeks under combined spinal-epidural anaesthesia with a good outcome for mother and both babies. After two weeks, however, the mother developed cardiac failure due to peripartum cardiomyopathy. To our knowledge, there have been no more then twenty reports of multiple myeloma in pregnant patients, of which only five have been diagnosed during pregnancy. This is the first case report describing anaesthetic implications and management of a parturient with multiple myeloma.
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PMID:Anaesthetic management of a pregnant patient with multiple myeloma. 2062 32


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