PMID- 36914606
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230317
IS  - 1738-5520 (Print)
IS  - 1738-5555 (Electronic)
IS  - 1738-5520 (Linking)
VI  - 53
IP  - 3
DP  - 2023 Mar
TI  - Clinical Course of Suspected Diagnosis of Pulmonary Tumor Thrombotic 
      Microangiopathy: A 10-Year Experience of Rapid Progressive Right Ventricular 
      Failure Syndrome in Advanced Cancer Patients.
PG  - 170-184
LID - 10.4070/kcj.2022.0252 [doi]
AB  - BACKGROUND AND OBJECTIVES: Several cases involving severe right ventricular (RV) 
      failure in advanced cancer patients have been found to be pulmonary tumor 
      thrombotic microangiopathies (PTTMs). This study aimed to discover the nature of 
      rapid RV failure syndrome with a suspected diagnosis of PTTM for better 
      diagnosis, treatment, and prognosis prediction in clinical practice. METHODS: 
      From 2011 to 2021, all patients with clinically suspected PTTM were derived from 
      the one tertiary cancer hospital with more than 2000 in-hospital bed. RESULTS: A 
      total of 28 cases of clinically suspected PTTM with one biopsy confirmed case 
      were included. The most common cancer types were breast (9/28, 32%) and the most 
      common tissue type was adenocarcinoma (22/26, 85%). The time interval from 
      dyspnea New York Heart Association (NYHA) Grade 2, 3, 4 to death, 
      thrombocytopenia to death, desaturation to death, admission to death, RV failure 
      to death, cardiogenic shock to death were 33.5 days, 14.5 days, 7.4 days, 6.4 
      days, 6.1 days, 6.0 days, 3.8 days and 1.2 days, respectively. The NYHA Grade 4 
      to death time was 7 days longer in those who received chemotherapy (7.1 days vs. 
      13.8 days, p value=0.030). However, anticoagulation, vasopressors or intensive 
      care could not change clinical course. CONCLUSIONS: Rapid RV failure syndrome 
      with a suspected diagnosis of PTTM showed a rapid progressive course from symptom 
      onset to death. Although chemotherapy was effective, increased life survival was 
      negligible, and treatments other than chemotherapy did not help to improve the 
      patient's prognosis.
CI  - Copyright (c) 2023. The Korean Society of Cardiology.
FAU - Bak, Minjung
AU  - Bak M
AUID- ORCID: 0000-0002-3340-7232
AD  - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Korea.
FAU - Kim, Minyeong
AU  - Kim M
AUID- ORCID: 0000-0002-6228-7313
AD  - Department of Radiology, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, Korea.
FAU - Lee, Boram
AU  - Lee B
AUID- ORCID: 0000-0002-7784-5971
AD  - Department of Pathology and Translational Genomics, Samsung Medical Center, 
      Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Kim, Eun Kyoung
AU  - Kim EK
AUID- ORCID: 0000-0002-7653-3503
AD  - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Korea.
FAU - Park, Taek Kyu
AU  - Park TK
AUID- ORCID: 0000-0003-1440-3583
AD  - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Korea.
FAU - Yang, Jeong Hoon
AU  - Yang JH
AUID- ORCID: 0000-0001-8138-1367
AD  - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Korea.
FAU - Kim, Duk-Kyung
AU  - Kim DK
AUID- ORCID: 0000-0002-2348-8948
AD  - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Korea.
FAU - Chang, Sung-A
AU  - Chang SA
AUID- ORCID: 0000-0001-5124-605X
AD  - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Korea. elisabet.chang@gmail.com.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - Korean Circ J
JT  - Korean circulation journal
JID - 101247141
PMC - PMC10011225
OTO - NOTNLM
OT  - Chemotherapy
OT  - Heart failure
OT  - Hypertension, pulmonary
OT  - Neoplasm
COIS- The authors have no financial conflicts of interest.
EDAT- 2023/03/15 06:00
MHDA- 2023/03/15 06:01
PMCR- 2023/03/01
CRDT- 2023/03/14 00:03
PHST- 2022/09/11 00:00 [received]
PHST- 2022/12/13 00:00 [revised]
PHST- 2023/01/04 00:00 [accepted]
PHST- 2023/03/14 00:03 [entrez]
PHST- 2023/03/15 06:00 [pubmed]
PHST- 2023/03/15 06:01 [medline]
PHST- 2023/03/01 00:00 [pmc-release]
AID - 53.170 [pii]
AID - 10.4070/kcj.2022.0252 [doi]
PST - ppublish
SO  - Korean Circ J. 2023 Mar;53(3):170-184. doi: 10.4070/kcj.2022.0252.