Levosimendan treatment as a „bridge therapy“ in a patient with metastatic testicular cancer and severe systolic heart failure - competition case report
Authors:
MUDr. Marie Pavlušová 1,2; MUDr. Roman Miklík, Ph.D. 1,3; prof. MUDr. Jindřich Špinar, CSc.; Fesc 1,2,3; MUDr. Šárka Bohatá, Ph.D. 4; MUDr. Mgr. Et Jiří Pařenica, Ph.D. 1,2,3
Authors‘ workplace:
Interní kardiologická klinika FN Brno
1; LF MU v Brně
2; Mezinárodní centrum klinického výzkumu FN u sv. Anny v Brně
3; Radiologická klinika FN Brno
4
Published in:
Kardiol Rev Int Med 2013, 15(4): 240-246
Category:
Overview
We report a case of a young male with non-ischemic cardiomyopathy who was admitted to our clinic with severe systolic heart failure. Etiology was unclear, ischemic heart disease was not confirmed. Subsequently, hemoptysis occurred and examinations revealed a disseminated tumor of testicular origin. During the course of cancer treatment, as well as during the current remission of the tumor, the patient requires rehospitalization for decompensation of heart failure, managed with levosimendan. According to hemodynamic and laboratory parameters this treatment is highly efficient, quickly helps to stabilize the patient and increases his chances of being placed on the waiting list for heart transplantation, as soon as the complete remission of the tumor has prevailed for five years. A possible association of the tumor and rapid onset of heart failure is also discussed.
Keywords:
heart failure – levosimendan – hemodynamics – testicular cancer
Sources
1. Špinar J, Vítovec J, Hradec J et al. Czech Society of Cardiology guidelines for the diagnosis and treatment of chronic heart failure 2011. Cor Vasa 2012; 54: e113–e134.
2. Miklík R, Špinar J, Pařenica J et al. Registry akutního srdečního selhání. Kardiologia pre prax 2010; 8: 67–73.
3. Parenica J, Spinar J, Vitovec J et al. Long-term survival following acute heart failure: the Acute Heart Failure Database Main registry (AHEAD Main). Eur J Intern Med 2013; 24: 151–160.
4. Spinar J, Parenica J, Vitovec J et al. Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry. Critical Care 2011; 15: R291.
5. Málek I. Výběr nemocných k ortotopické transplantaci srdce. In: Pirk J, Málek I. Transplantace srdce. Praha: Karolinum 2008: 76–77.
6. Albers P, Albrecht W, Algaba F et al. EAU Guidelines on testicular cancer: 2011 update. European Association of Urology. Actas Urol Esp 2012; 36: 127–145.
7. Levy WC, Mozaffarian D, Linker DT et al. The Seattle Heart Failure Model: prediction of survival in heart failure. Circulation 2006; 113: 1424–1433.
8. Špinar J, Vítovec J. Levosimendan – Revised indications and posology. Cor Vasa 2007; 49: 108–110.
9. De Luca L, Colucci WS, Nieminen MS et al. Evidence-based use of levosimendan in different clinical settings. Eur Heart J 2006; 27: 1908–1920.
10. Landoni G, Biondi-Zoccai G, Greco M et al. Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. Crit Care Med 2012; 40: 634–646.
11. Miklík R, Pařenica J, Felšöci M et al. Levosimendan v léčbě akutního srdečního selhání – zkušenosti z kardiologické kliniky. Cor Vasa 2009; 51: 507–512.
12. Teerlink JR, Cotter G, Davison BA et al. Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised placebo-controlled trial. Lancet 2013; 381: 29–39.
13. Metra M, Cotter G, Davison BA et al. Effect of serelaxin on cardiac, renal, and hepatic biomarkers in the Relaxin in Acute Heart Failure (RELAX-AHF) development program: correlation with outcomes. J Am Coll Cardiol 2013; 61: 196–206.
14. Carlson P, Jefferies JL, Kearney D et al. Refractory dilated cardiomyopathy associated with metastatic neuroblastoma. Pediatr Blood Cancer 2010; 55: 736–738.
15. Kay S, Schneider V, Litt J. Choriocarcinoma of the mesosalpinx masquerading as congestive heart failure: ultrastructural observations of the tumor. Int J Gynecol Pathol 1983; 2: 72–87.
16. Koller L, Richter B, Goliasch G et al. CD4+ CD28(null) cells are an independent predictor of mortality in patients with heart failure. Atherosclerosis 2013; 230: 414–416.
17. Cordero-Reyes AM, Youker KA, Torre-Amione G. The role of B-cells in heart failure. Methodist Debakey Cardiovasc J 2013; 9: 15–19.
Labels
Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2013 Issue 4
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