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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Case report

Chemotherapy-induced Takotsubo cardiomyopathy, a case report and review of the literature

Authors: Matteo Coen, Fabio Rigamonti, Arnaud Roth, Thibaud Koessler

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Several chemotherapy molecules, monoclonal antibodies and tyrosine kinase inhibitors, have been linked to Takotsubo cardiomyopathy (TC).

Case presentation

In this article, we describe the case of a 45-year-old woman who developed TC after receiving an intra-arterial and intra-venous polychemotherapy for locally advanced epidermoid carcinoma of the anal canal. This is the first described case of TC associated with intra-arterial chemotherapy.

Conclusions

A review of the literature points to 5-fluorouracil as the most common molecule associated with TC and highlights the potential risk associated with rechallenging patient with the same drug.
Literature
1.
Kridel R, Cochet S, Roche B, Bressoud A, Gervaz P, Betz M, et al. Successful closure of anal cancer-related fistulas with upfront intra-arterial chemotherapy: a report of 8 cases. Dis Colon Rectum. 2011;54(5):566–9.
2.
Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB 3rd, Thomas CR Jr, et al. Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial. JAMA. 2008;299(16):1914–21.
3.
Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med. 2004; 7;141(11):858-865. Review.
4.
Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J. 2008;155(3):408–17.CrossRefPubMed
5.
Floyd JD, Nguyen DT, Lobins RL, Bashir Q, Doll DC, Perry MC. Cardiotoxicity of cancer therapy. J Clin Oncol. 2005; 20;23(30):7685-7696.
6.
Sato H, Tateishi H, Uchida T. Takotsubo-type cardiomyopathy due to multivessel spasm. In: Kodama K, Haze K, Hon M, editors. Clinical aspect of myocardial injury: from ischemia to heart failure. Tokyo, Japan: Kagakuhyouronsha; 1990. p. 56–64.
7.
Yoshikawa T. Takotsubo cardiomyopathy, a new concept of cardiomyopathy: clinical features and pathophysiology. Int J Cardiol. 2015,1;182:297-303.
8.
Gopalakrishnan M, Hassan A, Villines D, Nasr S, Chandrasekaran M, Klein LW. Predictors of short- and long-term outcomes of Takotsubo cardiomyopathy. Am J Cardiol. 2015, 15;116(10):1586-1590.
9.
Ghadri JR, Ruschitzka F, Lüscher TF, Templin C. Takotsubo cardiomyopathy: still much more to learn. Heart. 2014;100(22):1804–12.CrossRefPubMed
10.
Sharkey SW, Maron BJ. Epidemiology and clinical profile of Takotsubo cardiomyopathy. Circ J. 2014;78(9):2119–28.CrossRefPubMed
11.
Sharkey SW, Pink VR, Lesser JR, Garberich RF, Maron MS, Maron BJ. Clinical profile of patients with high-risk Tako-Tsubo Cardiomyopathy. Am J Cardiol. 2015;116(5):765–72.CrossRefPubMed
12.
Bybee KA, Prasad A. Stress-related cardiomyopathy syndromes. Circulation. 2008, 22;118(4):397-409.
13.
Komamura K, Fukui M, Iwasaku T, Hirotani S, Masuyama T. Takotsubo cardiomyopathy: Pathophysiology, diagnosis and treatment. World J Cardiol. 2014, 26;6(7):602-9.
14.
15.
Smith SA, Auseon AJ. Chemotherapy-induced takotsubo cardiomyopathy. Heart Fail Clin. 2013;9(2):233–42. xCrossRefPubMed
16.
Madias JE. Is Takotsubo syndrome in patients receiving chemotherapy drug-specific? World J Clin Cases. 2015, 16;3(2):204-205.
17.
Ozturk MA, Ozveren O, Cinar V, Erdik B, Oyan B. Takotsubo syndrome: an underdiagnosed complication of 5-fluorouracil mimicking acute myocardial infarction. Blood Coagul Fibrinolysis. 2013;24(1):90–4.CrossRefPubMed
18.
Bhakta S, Flick SM, Cooney MM, Greskovich JF, Gilkeson RC, Remick SC, et al. Myocardial stunning following combined modality combretastatin-based chemotherapy: two case reports and review of the literature. Clin Cardiol. 2009;32(12):E80–4.
19.
Radhakrishnan V, Bakhshi S. 5-fluorouracil-induced acute dilated cardiomyopathy in a pediatric patient. J Pediatr Hematol Oncol. 2011;33(4):323.CrossRefPubMed
20.
Knott K, Starling N, Rasheed S, Foran J, Cafferkey C, Rosen S, Nicholson A, Baksi J, Lyon A. A case of Takotsubo syndrome following 5-fluorouracil chemotherapy. Int J Cardiol. 2014 15;177(2):e65-e67.
21.
Kobayashi N, Hata N, Yokoyama S, Shinada T, Shirakabe A, Mizuno K. A case of Takotsubo cardiomyopathy during 5-fluorouracil treatment for rectal adenocarcinoma. J Nippon Med Sch. 2009;76(1):27–33.CrossRefPubMed
22.
Stewart T, Pavlakis N, Ward M. Cardiotoxicity with 5-fluorouracil and capecitabine: more than just vasospastic angina. Intern Med J. 2010;40(4):303–7.CrossRefPubMed
23.
Cheriparambil KM, Vasireddy H, Kuruvilla A, Gambarin B, Makan M, Saul BI. Acute reversible cardiomyopathy and thromboembolism after cisplatin and 5-fluorouracil chemotherapy--a case report. Angiology. 2000;51(10):873–8.CrossRefPubMed
24.
Dalzell JR, Samuel LM. The spectrum of 5-fluorouracil cardiotoxicity. Anti-Cancer Drugs. 2009;20(1):79–80. ReviewCrossRefPubMed
25.
Basselin C, Fontanges T, Descotes J, Chevalier P, Bui-Xuan B, Feinard G, et al. 5-fluorouracil-induced Tako-Tsubo-like syndrome. Pharmacotherapy. 2011;31(2):226.
26.
Grunwald MR, Howie L, Diaz LA Jr. Takotsubo cardiomyopathy and fluorouracil: case report and review of the literature. J Clin Oncol. 2012, 10;30(2):e11–e14.
27.
Qasem A, Bin Abdulhak AA, Aly A, Moormeier J. Capecitabine-Induced Takotsubo Cardiomyopathy: A Case Report and Literature Review. Am J Ther. 2016;23(5):e1188–92.
28.
Y-Hassan S, Tornvall P, Törnerud M, Henareh L. Capecitabine caused cardiogenic shock through induction of global Takotsubo syndrome. Cardiovasc Revasc med. 2013;14(1):57–61.CrossRefPubMed
29.
Kim L, Karas M, Wong SC. Chemotherapy-induced takotsubo cardiomyopathy. J Invasive Cardiol. 2008;20(12):E338–40.PubMed
30.
Ovadia D, Esquenazi Y, Bucay M, Bachier CR. Association between takotsubo cardiomyopathy and axitinib: case report and review of the literature. J Clin Oncol. 2015, 1; 33(1):e1-e3.
31.
Franco TH, Khan A, Joshi V, Thomas B. Takotsubo cardiomyopathy in two men receiving bevacizumab for metastatic cancer. Ther Clin Risk Manag. 2008;4(6):1367–70.CrossRefPubMedPubMedCentral
32.
Ng KH, Dearden C, Gruber P. Rituximab-induced Takotsubo syndrome: more cardiotoxic than it appears? BMJ Case Rep. 2015;2:2015.
33.
Goel S, Sharma A, Garg A, Chandra A, Shetty V. Chemotherapy induced Takotsubo cardiomyopathy. World J Clin Cases. 2014, 16;2(10):565-568.
34.
Fernandez SF, Basra M, Canty JM Jr. Takotsubo Cardiomyopathy following initial chemotherapy presenting with syncope and Cardiogenic shock ? A case report and literature review. J Clinic Experiment Cardiol. 2:124.
35.
Gianni M, Dentali F, Lonn E. 5 flourouracil-induced apical ballooning syndrome: a case report. Blood Coagul Fibrinolysis. 2009;20(4):306–8.CrossRefPubMed
36.
Lim SH, Wilson SM, Hunter A, Hill J, Beale P. Takotsubo cardiomyopathy and 5-fluorouracil: getting to the heart of the matter. Case Rep Oncol Med. 2013;2013:206765.PubMedPubMedCentral
37.
Baumann S, Huseynov A, Goranova D, Faust M, Behnes M, Nolte F, et al. Takotsubo cardiomyopathy after systemic consolidation therapy with high-dose intravenous cytarabine in a patient with acute myeloid leukemia. Oncol res Treat. 2014;37(9):487–90.
38.
Toyooka S, Akagi S, Furukawa M, Nakamura K, Soh J, Yamane M, et al. Takotsubo cardiomyopathy associated with pulmonary resections after induction chemoradiotherapy for non-small cell lung cancer. Gen Thorac Cardiovasc Surg. 2012;60(9):599–602.
39.
Numico G, Sicuro M, Silvestris N, Mozzicafreddo A, Trogu A, Malossi A, Cristofano A, Thiebat B. Takotsubo syndrome in a patient treated with sunitinib for renal cancer. J Clin Oncol. 2012, 20;30(24):e218-e220.
40.
Madias JE. Cytarabine, venous catheter removal, sepsis, diagnosis of malignancy, and takotsubo syndrome. Oncol Res Treat. 2015;38(3):125.CrossRefPubMed
41.
Schweizer MT, Mehta R, Salgia R, Villaflor VM. Takotsubo cardiomyopathy in a patient with squamous cell esophageal carcinoma. J Clin Oncol. 2011, 10;29(20):e598-e600.
42.
Burgy M, Brossat H, Barthelemy P, Imperiale A, Trinh A, Hazam CA, et al. First report of trastuzumab treatment after postoperative Takotsubo cardiomyopathy. Anticancer Res. 2014;34(7):3579–82.
43.
Khanji M, Nolan S, Gwynne S, Pudney D, Ionescu A. Tako-Tsubo syndrome after trastuzumab - an unusual complication of chemotherapy for breast cancer. Clin Oncol (R Coll Radiol). 2013;25(5):329.CrossRef
Metadata
Title
Chemotherapy-induced Takotsubo cardiomyopathy, a case report and review of the literature
Authors
Matteo Coen
Fabio Rigamonti
Arnaud Roth
Thibaud Koessler
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3384-4

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