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Temporary left ventricular assist device for complete recovery from reversible acute heart failure due to tumor necrosis factor-α inhibitor
We present the case of a 38-year-old woman with symptoms of acute heart failure (HF). In the previous months, she received tumor necrosis factor (TNF)-α inhibitors for the treatment of arthritis secondary to Crohn’s disease. She initially received etanercept (Enbrel) for nearly 1 year and subsequent...
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Published in: | Anatolian journal of cardiology 2019-07, Vol.22 (1), p.46-48 |
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creator | Soucy-Giguere, Marie-Camille Charbonneau, Éric Cinq Mars, Alexandre Dubois, Michelle Sénéchal, Mario |
description | We present the case of a 38-year-old woman with symptoms of acute heart failure (HF). In the previous months, she received tumor necrosis factor (TNF)-α inhibitors for the treatment of arthritis secondary to Crohn’s disease. She initially received etanercept (Enbrel) for nearly 1 year and subsequently received infliximab (Remicade) for 6 months. Echocardiograms following the etanercept therapy were normal. Since her disease did not respond well to etanercept, she received 16 treatments of infliximab, at the end of which HF symptoms developed, with rapid clinical deterioration. Her echocardiogram demonstrated dilated cardiomyopathy with severe biventricular dysfunction and left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) |
doi_str_mv | 10.14744/AnatolJCardiol.2019.67124 |
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In the previous months, she received tumor necrosis factor (TNF)-α inhibitors for the treatment of arthritis secondary to Crohn’s disease. She initially received etanercept (Enbrel) for nearly 1 year and subsequently received infliximab (Remicade) for 6 months. Echocardiograms following the etanercept therapy were normal. Since her disease did not respond well to etanercept, she received 16 treatments of infliximab, at the end of which HF symptoms developed, with rapid clinical deterioration. Her echocardiogram demonstrated dilated cardiomyopathy with severe biventricular dysfunction and left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) <20% with severe functional mitral and tricuspid regurgitation. Her extensive diagnostic work-up, including pathological examination of endomyocardial biopsy, was normal. Despite optimal treatment of HF, her status did not improve, and a left ventricular assist device (LVAD, HeartMate II) was implanted. The evolution was unremarkable, and she rapidly recovered in the following months, with LVEF reaching ≥45%. Based on the patient’s clinical improvement and LVEF recuperation, LVAD was removed. Her functional status and LVEF remained stable after LVAD explantation. Therefore, the very probable etiology of the precipitated HF was infliximab toxicity.</description><identifier>ISSN: 2149-2263</identifier><identifier>EISSN: 2149-2271</identifier><identifier>EISSN: 2149-2263</identifier><identifier>DOI: 10.14744/AnatolJCardiol.2019.67124</identifier><identifier>PMID: 31264660</identifier><language>eng</language><publisher>Turkey: Kare Publishing</publisher><subject>Adult ; Arthritis - drug therapy ; Arthritis - etiology ; Biopsy ; Blood pressure ; Cardiac arrhythmia ; Cardiology ; Cardiomyocytes ; Cardiomyopathy ; Cardiomyopathy, Dilated - complications ; Cardiomyopathy, Dilated - diagnosis ; Cardiomyopathy, Dilated - drug therapy ; Cardiotonic Agents - therapeutic use ; Case Reports ; Clinical deterioration ; Crohn Disease - complications ; Crohn's disease ; Ejection fraction ; Electrocardiography ; Etanercept - therapeutic use ; Family medical history ; Female ; Furosemide - therapeutic use ; Heart attacks ; Heart failure ; Heart Failure - chemically induced ; Heart Failure - therapy ; Heart-Assist Devices ; Humans ; Infliximab - adverse effects ; Infliximab - therapeutic use ; lvad ; Milrinone - therapeutic use ; Monoclonal antibodies ; Necrosis ; NMR ; Nuclear magnetic resonance ; Patients ; Pulmonary arteries ; Rheumatoid arthritis ; tnf-alpha inhibitors ; toxicity ; Tumor Necrosis Factor-alpha - antagonists & inhibitors ; Tumor necrosis factor-TNF ; Ultrasonic imaging</subject><ispartof>Anatolian journal of cardiology, 2019-07, Vol.22 (1), p.46-48</ispartof><rights>2019. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at http://www.anakarder.com/Copyright</rights><rights>Copyright: © 2019 Turkish Society of Cardiology 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2257692405/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2257692405?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,44590,53791,53793,74998</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31264660$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soucy-Giguere, Marie-Camille</creatorcontrib><creatorcontrib>Charbonneau, Éric</creatorcontrib><creatorcontrib>Cinq Mars, Alexandre</creatorcontrib><creatorcontrib>Dubois, Michelle</creatorcontrib><creatorcontrib>Sénéchal, Mario</creatorcontrib><title>Temporary left ventricular assist device for complete recovery from reversible acute heart failure due to tumor necrosis factor-α inhibitor</title><title>Anatolian journal of cardiology</title><addtitle>Anatol J Cardiol</addtitle><description>We present the case of a 38-year-old woman with symptoms of acute heart failure (HF). In the previous months, she received tumor necrosis factor (TNF)-α inhibitors for the treatment of arthritis secondary to Crohn’s disease. She initially received etanercept (Enbrel) for nearly 1 year and subsequently received infliximab (Remicade) for 6 months. Echocardiograms following the etanercept therapy were normal. Since her disease did not respond well to etanercept, she received 16 treatments of infliximab, at the end of which HF symptoms developed, with rapid clinical deterioration. Her echocardiogram demonstrated dilated cardiomyopathy with severe biventricular dysfunction and left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) <20% with severe functional mitral and tricuspid regurgitation. Her extensive diagnostic work-up, including pathological examination of endomyocardial biopsy, was normal. Despite optimal treatment of HF, her status did not improve, and a left ventricular assist device (LVAD, HeartMate II) was implanted. The evolution was unremarkable, and she rapidly recovered in the following months, with LVEF reaching ≥45%. Based on the patient’s clinical improvement and LVEF recuperation, LVAD was removed. Her functional status and LVEF remained stable after LVAD explantation. Therefore, the very probable etiology of the precipitated HF was infliximab toxicity.</description><subject>Adult</subject><subject>Arthritis - drug therapy</subject><subject>Arthritis - etiology</subject><subject>Biopsy</subject><subject>Blood pressure</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiomyocytes</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Dilated - complications</subject><subject>Cardiomyopathy, Dilated - diagnosis</subject><subject>Cardiomyopathy, Dilated - drug therapy</subject><subject>Cardiotonic Agents - therapeutic use</subject><subject>Case Reports</subject><subject>Clinical deterioration</subject><subject>Crohn Disease - complications</subject><subject>Crohn's disease</subject><subject>Ejection fraction</subject><subject>Electrocardiography</subject><subject>Etanercept - therapeutic use</subject><subject>Family medical history</subject><subject>Female</subject><subject>Furosemide - therapeutic use</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart Failure - 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In the previous months, she received tumor necrosis factor (TNF)-α inhibitors for the treatment of arthritis secondary to Crohn’s disease. She initially received etanercept (Enbrel) for nearly 1 year and subsequently received infliximab (Remicade) for 6 months. Echocardiograms following the etanercept therapy were normal. Since her disease did not respond well to etanercept, she received 16 treatments of infliximab, at the end of which HF symptoms developed, with rapid clinical deterioration. Her echocardiogram demonstrated dilated cardiomyopathy with severe biventricular dysfunction and left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) <20% with severe functional mitral and tricuspid regurgitation. Her extensive diagnostic work-up, including pathological examination of endomyocardial biopsy, was normal. Despite optimal treatment of HF, her status did not improve, and a left ventricular assist device (LVAD, HeartMate II) was implanted. The evolution was unremarkable, and she rapidly recovered in the following months, with LVEF reaching ≥45%. Based on the patient’s clinical improvement and LVEF recuperation, LVAD was removed. Her functional status and LVEF remained stable after LVAD explantation. Therefore, the very probable etiology of the precipitated HF was infliximab toxicity.</abstract><cop>Turkey</cop><pub>Kare Publishing</pub><pmid>31264660</pmid><doi>10.14744/AnatolJCardiol.2019.67124</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Arthritis - drug therapy Arthritis - etiology Biopsy Blood pressure Cardiac arrhythmia Cardiology Cardiomyocytes Cardiomyopathy Cardiomyopathy, Dilated - complications Cardiomyopathy, Dilated - diagnosis Cardiomyopathy, Dilated - drug therapy Cardiotonic Agents - therapeutic use Case Reports Clinical deterioration Crohn Disease - complications Crohn's disease Ejection fraction Electrocardiography Etanercept - therapeutic use Family medical history Female Furosemide - therapeutic use Heart attacks Heart failure Heart Failure - chemically induced Heart Failure - therapy Heart-Assist Devices Humans Infliximab - adverse effects Infliximab - therapeutic use lvad Milrinone - therapeutic use Monoclonal antibodies Necrosis NMR Nuclear magnetic resonance Patients Pulmonary arteries Rheumatoid arthritis tnf-alpha inhibitors toxicity Tumor Necrosis Factor-alpha - antagonists & inhibitors Tumor necrosis factor-TNF Ultrasonic imaging |
title | Temporary left ventricular assist device for complete recovery from reversible acute heart failure due to tumor necrosis factor-α inhibitor |
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