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Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature

Takotsubo syndrome (TTS) is an uncommon cardiovascular condition also known as stress-induced cardiomyopathy or broken heart disease. The syndrome, characterized by acute non-coronary segmental ventricular dysfunction, commonly occurs as a reaction to severe emotional or physical stress and can caus...

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Autores principales: Monti, Manlio, Cortesi, Pietro, Vespignani, Roberto, Bronico, Ilaria, Gallio, Chiara, Flospergher, Michele, Matteucci, Laura, Frassineti, Giovanni Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9179013/
https://www.ncbi.nlm.nih.gov/pubmed/35692777
http://dx.doi.org/10.3389/fonc.2022.875391
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author Monti, Manlio
Cortesi, Pietro
Vespignani, Roberto
Bronico, Ilaria
Gallio, Chiara
Flospergher, Michele
Matteucci, Laura
Frassineti, Giovanni Luca
author_facet Monti, Manlio
Cortesi, Pietro
Vespignani, Roberto
Bronico, Ilaria
Gallio, Chiara
Flospergher, Michele
Matteucci, Laura
Frassineti, Giovanni Luca
author_sort Monti, Manlio
collection PubMed
description Takotsubo syndrome (TTS) is an uncommon cardiovascular condition also known as stress-induced cardiomyopathy or broken heart disease. The syndrome, characterized by acute non-coronary segmental ventricular dysfunction, commonly occurs as a reaction to severe emotional or physical stress and can cause significant problems. Several classes of chemotherapeutic agents that are known to be cardiotoxic have been shown to be associated with TTS in cancer patients. Describing a case of TTS from chemotherapy and/or monoclonal antibody is important because these drugs are widely used and their temporary or permanent suspension could compromise the success of treatment. The detection and reporting of suspected adverse drug reactions in clinical practice are the foundations of postmarketing surveillance. We performed a retrospective analysis of a large number of patients followed at our cancer centre to identify drugs that could lead to the onset of TTS, focusing our attention on 2 monoclonal antibodies, bevacizumab and rituximab plus chemotherapy. A search was carried out for the word “Takotsubo” in database sources such as in PubMed, in medical oncology, radiology and cardiology electronic clinical records. From October 2007 to March 2021, of the 79,005 patients seen or treated for any kind of malignancy at our institute, 9 had a diagnosis of TTS (4 before and 5 after the diagnosis of malignancy). Only 2 patients had TTS after treatment with the anticancer drugs, bevacizumab and rituximab plus chemotherapy. These two patients were hospitalised, one for subocclusion while the other for pulmonary embolism (PE) with a life threatening condition and in need of intravenous catecholamines. For both patients, an ECG, echocardiography and coronary angiography were performed as well as blood tests with a subsequent diagnosis of TTS and both received cardiological treatment with resolution of the clinical picture. A reassessment of the two cases found that a subocclusion and intravenous catecholamines appeared to be the most likely triggers. In conclusion, TTS is rare in cancer patients. Identifying TTS triggers could be useful because it could induce therapeutic changes.
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spelling pubmed-91790132022-06-10 Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature Monti, Manlio Cortesi, Pietro Vespignani, Roberto Bronico, Ilaria Gallio, Chiara Flospergher, Michele Matteucci, Laura Frassineti, Giovanni Luca Front Oncol Oncology Takotsubo syndrome (TTS) is an uncommon cardiovascular condition also known as stress-induced cardiomyopathy or broken heart disease. The syndrome, characterized by acute non-coronary segmental ventricular dysfunction, commonly occurs as a reaction to severe emotional or physical stress and can cause significant problems. Several classes of chemotherapeutic agents that are known to be cardiotoxic have been shown to be associated with TTS in cancer patients. Describing a case of TTS from chemotherapy and/or monoclonal antibody is important because these drugs are widely used and their temporary or permanent suspension could compromise the success of treatment. The detection and reporting of suspected adverse drug reactions in clinical practice are the foundations of postmarketing surveillance. We performed a retrospective analysis of a large number of patients followed at our cancer centre to identify drugs that could lead to the onset of TTS, focusing our attention on 2 monoclonal antibodies, bevacizumab and rituximab plus chemotherapy. A search was carried out for the word “Takotsubo” in database sources such as in PubMed, in medical oncology, radiology and cardiology electronic clinical records. From October 2007 to March 2021, of the 79,005 patients seen or treated for any kind of malignancy at our institute, 9 had a diagnosis of TTS (4 before and 5 after the diagnosis of malignancy). Only 2 patients had TTS after treatment with the anticancer drugs, bevacizumab and rituximab plus chemotherapy. These two patients were hospitalised, one for subocclusion while the other for pulmonary embolism (PE) with a life threatening condition and in need of intravenous catecholamines. For both patients, an ECG, echocardiography and coronary angiography were performed as well as blood tests with a subsequent diagnosis of TTS and both received cardiological treatment with resolution of the clinical picture. A reassessment of the two cases found that a subocclusion and intravenous catecholamines appeared to be the most likely triggers. In conclusion, TTS is rare in cancer patients. Identifying TTS triggers could be useful because it could induce therapeutic changes. Frontiers Media S.A. 2022-05-26 /pmc/articles/PMC9179013/ /pubmed/35692777 http://dx.doi.org/10.3389/fonc.2022.875391 Text en Copyright © 2022 Monti, Cortesi, Vespignani, Bronico, Gallio, Flospergher, Matteucci and Frassineti https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Monti, Manlio
Cortesi, Pietro
Vespignani, Roberto
Bronico, Ilaria
Gallio, Chiara
Flospergher, Michele
Matteucci, Laura
Frassineti, Giovanni Luca
Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature
title Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature
title_full Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature
title_fullStr Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature
title_full_unstemmed Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature
title_short Takotsubo Syndrome (TTS) in Onco-Hematologic Patients: Retrospective Analysis and Focus on the Correlation or Not With Anticancer Drugs. Case Reports and Review of the Literature
title_sort takotsubo syndrome (tts) in onco-hematologic patients: retrospective analysis and focus on the correlation or not with anticancer drugs. case reports and review of the literature
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9179013/
https://www.ncbi.nlm.nih.gov/pubmed/35692777
http://dx.doi.org/10.3389/fonc.2022.875391
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