PMID- 30840967
OWN - NLM
STAT- MEDLINE
DCOM- 20190514
LR  - 20190514
IS  - 1421-9794 (Electronic)
IS  - 0009-3157 (Linking)
VI  - 63
IP  - 6
DP  - 2018
TI  - Ivabradine in Cancer Treatment-Related Left Ventricular Dysfunction.
PG  - 315-320
LID - 10.1159/000495576 [doi]
AB  - BACKGROUND: Patients developing cancer treatment-related left ventricular 
      dysfunction (CTrLVD) require a prompt therapy. Hypotension, dizziness, and 
      fatigue often limit the use of angiotensin-converting enzyme inhibitors (ACEi), 
      angiotensin receptor blockers (ARB), and beta-blockers (BB) in cancer patients who 
      may already be afflicted by these symptoms. Ivabradine is a heart rate-lowering 
      drug that does not cause hypotension and may be used in heart failure with 
      reduced left ventricular ejection fraction (LVEF). OBJECTIVE: The aim of this 
      paper was to investigate the role of ivabradine to treat CTrLVD. METHODS: A 
      retrospective analysis in a cohort of 30 patients with CTrLVD (LVEF < 50%) 
      receiving ivabradine on top of the maximal tolerated dose of ACEi/ARB and BB was 
      performed. We evaluated cardiovascular treatment, oncologic treatment, LVEF, 
      functional class (New York Heart Association [NYHA]), and fatigue during the 
      study period. RESULTS: Ivabradine was initially started at the dose of 2.5 
      mg/b.i.d. in most patients and then carefully titrated. Hypotension (70%) and 
      fatigue (77%) were the main causes limiting the treatment with ACEi/ARB and BB. 
      After a mean follow-up of 6.5 months, LVEF increased from 45.1% (SD = 6.4) to 
      53.2% (SD = 3.9; p < 0.001). When patients were analyzed according to the type of 
      cancer therapy, no difference in LVEF changes across the groups was found. NYHA 
      class ameliorated in 11 patients, while fatigue improved in 8 patients. No 
      serious cardiovascular side effects were reported. CONCLUSIONS: The ability to 
      improve symptoms and LVEF in unfit cancer patients makes ivabradine a reasonable 
      pharmacological tool for treating CTrLVD.
CI  - (c) 2019 S. Karger AG, Basel.
FAU - Sarocchi, Matteo
AU  - Sarocchi M
AD  - Cardiovascular Disease Unit, San Martino Policlinic Hospital, Genoa, Italy.
AD  - Department of Internal Medicine, University of Genoa, Genoa, Italy.
FAU - Arboscello, Eleonora
AU  - Arboscello E
AD  - Emergency Medicine Unit, San Martino Policlinic Hospital, Genoa, Italy.
FAU - Ghigliotti, Giorgio
AU  - Ghigliotti G
AD  - Cardiovascular Disease Unit, San Martino Policlinic Hospital, Genoa, Italy.
AD  - Department of Internal Medicine, University of Genoa, Genoa, Italy.
FAU - Murialdo, Roberto
AU  - Murialdo R
AD  - Internal Medicine Unit, San Martino Policlinic Hospital, Genoa, Italy.
FAU - Bighin, Claudia
AU  - Bighin C
AD  - Medical Oncology Unit, San Martino Policlinic Hospital, Genoa, Italy.
FAU - Gualandi, Francesca
AU  - Gualandi F
AD  - Haematology Unit, San Martino Policlinic Hospital, Genoa, Italy.
FAU - Sicbaldi, Vera
AU  - Sicbaldi V
AD  - Internal Medicine Unit, San Martino Policlinic Hospital, Genoa, Italy.
FAU - Balbi, Manrico
AU  - Balbi M
AD  - Cardiovascular Disease Unit, San Martino Policlinic Hospital, Genoa, Italy.
AD  - Department of Internal Medicine, University of Genoa, Genoa, Italy.
FAU - Brunelli, Claudio
AU  - Brunelli C
AD  - Cardiovascular Disease Unit, San Martino Policlinic Hospital, Genoa, Italy.
AD  - Department of Internal Medicine, University of Genoa, Genoa, Italy.
FAU - Spallarossa, Paolo
AU  - Spallarossa P
AD  - Cardiovascular Disease Unit, San Martino Policlinic Hospital, Genoa, Italy, 
      paolo.spallarossa@unige.it.
LA  - eng
PT  - Journal Article
DEP - 20190306
PL  - Switzerland
TA  - Chemotherapy
JT  - Chemotherapy
JID - 0144731
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Anthracyclines)
RN  - 0 (Cardiovascular Agents)
RN  - 3H48L0LPZQ (Ivabradine)
RN  - P188ANX8CK (Trastuzumab)
SB  - IM
MH  - Adrenergic beta-Antagonists/adverse effects/therapeutic use
MH  - Adult
MH  - Aged
MH  - Angiotensin Receptor Antagonists/adverse effects/therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/adverse effects/therapeutic use
MH  - Anthracyclines/adverse effects/therapeutic use
MH  - Cardiovascular Agents/*adverse effects/therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Fatigue/etiology
MH  - Female
MH  - Heart Rate
MH  - Humans
MH  - Ivabradine/*adverse effects/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/drug therapy
MH  - Retrospective Studies
MH  - Trastuzumab/adverse effects/therapeutic use
MH  - Ventricular Dysfunction, Left/*etiology
OTO - NOTNLM
OT  - Adverse drug reaction
OT  - Cancer
OT  - Cardio-oncology
OT  - Cardiotoxicity
OT  - Heart failure
OT  - Hypotension
OT  - Ivabradine
EDAT- 2019/03/07 06:00
MHDA- 2019/05/15 06:00
CRDT- 2019/03/07 06:00
PHST- 2018/08/24 00:00 [received]
PHST- 2018/11/19 00:00 [accepted]
PHST- 2019/03/07 06:00 [pubmed]
PHST- 2019/05/15 06:00 [medline]
PHST- 2019/03/07 06:00 [entrez]
AID - 000495576 [pii]
AID - 10.1159/000495576 [doi]
PST - ppublish
SO  - Chemotherapy. 2018;63(6):315-320. doi: 10.1159/000495576. Epub 2019 Mar 6.