The anticancer efficacy of doxorubicin (DOX) is dose-limited because of cardiomyopathy, the most significant adverse effect. Initially, cardiotoxicity develops clinically silently, but it eventually appears as dilated cardiomyopathy with a very poor prognosis. Dexrazoxane (DEX) is the only FDA-approved drug to prevent the development of anthracycline cardiomyopathy, but its efficacy is insufficient. Carvedilol (CVD) is another product being tested in clinical trials for the same indication. This study’s objective was to evaluate anthracycline cardiotoxicity in rats treated with CVD in combination with DEX. The studies were conducted using male Wistar rats receiving DOX (1.6 mg/kg b.w. i.p., cumulative dose: 16 mg/kg b.w.), DOX and DEX (25 mg/kg b.w. i.p.), DOX and CVD (1 mg/kg b.w. i.p.), or a combination (DOX + DEX + CVD) for 10 weeks. Afterward, in the 11th and 21st weeks of the study, echocardiography (ECHO) was performed, and the tissues were collected. The addition of CVD to DEX as a cardioprotective factor against DOX had no favorable advantages in terms of functional (ECHO), morphological (microscopic evaluation), and biochemical alterations (cardiac troponin I and brain natriuretic peptide levels), as well as systemic toxicity (mortality and presence of ascites). Moreover, alterations caused by DOX were abolished at the tissue level by DEX; however, when CVD was added, the persistence of DOX-induced unfavorable alterations was observed. The addition of CVD normalized the aberrant expression of the vast majority of indicated genes in the DOX + DEX group. Overall, the results indicate that there is no justification to use a simultaneous treatment of DEX and CVD in DOX-induced cardiotoxicity.
A 69-year-old patient was admitted to the Department of Cardiology due to an accidental finding on a chest X-ray, enlarged heart outline, accompanied by worsening of heart failure to NYHA II with LVEF, about 30%. In the X-ray description, an enlargement of the left atrium silhouette with local calcifications. The patient underwent TTE, confirming the presence of a pedunculated tumor of the left atrium attached to the ceiling measuring 3.5x3.5x2.2 cm. Due to the ischemic heart disease manifestation patient uderwent coronarography confirming the presence of single-vessel coronary artery disease with changes in the middle segment of the LAD. Patient was treated with CABG LIMA-LAD surgery and removeal the left atrial tumor. Post operation tissue material prooved the preseance of left atrium myxoma. The postoperative course was uneventful, the patient was discharged home.
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