Pathological changes of the myocardium in reworsening of anthracycline-induced cardiomyopathy after explant of a left ventricular assist device

Nagoya J Med Sci. 2020 Feb;82(1):129-134. doi: 10.18999/nagjms.82.1.129.

Abstract

We herein report the long-term changes in cardiac function and pathological findings after successful explantation of a left ventricular assist device in a 42-year-old patient with anthracycline-induced cardiomyopathy with reworsening heart failure. Endomyocardial biopsy samples revealed that the cardiomyocyte diameter decreased and collagen volume fraction increased just after left ventricular assist device explantation. The collagen volume fraction decreased after 6 months, despite preserved systolic function. At 5 years after left ventricular assist device explantation, the systolic function markedly decreased and cardiomyocyte diameter increased. Pathological changes of the myocardium may enable the identification of cardiac dysfunction prior to echocardiographic changes in patients with reworsening heart failure after left ventricular assist device explantation.

Keywords: anthracycline-induced cardiomyopathy; cardiac pathology; left ventricular assist device; reworsening heart failure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cardiomyopathies / chemically induced*
  • Cardiomyopathies / pathology
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / therapy
  • Cardiotoxicity
  • Daunorubicin / adverse effects*
  • Device Removal / adverse effects*
  • Disease Progression
  • Female
  • Fibrosis
  • Heart-Assist Devices*
  • Humans
  • Idarubicin / adverse effects*
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Myocardium / pathology*
  • Time Factors
  • Ventricular Function, Left

Substances

  • Idarubicin
  • Daunorubicin