Fidest – Agenzia giornalistica/press agency

Quotidiano di informazione – Anno 31 n° 301

Posts Tagged ‘cardiomyopathy’

Do men have worse chemotherapy-induced cardiomyopathy than women?

Posted by fidest press agency su giovedì, 25 maggio 2017

Praga, Stare Mesto 1983, mostra Jappelli 01Prague, Czech Republic Men seem to have worse chemotherapy-induced cardiomyopathy than women despite receiving similar cancer treatments, according to research presented today at EuroCMR 2017. “Cancer patients are living longer because of improved treatment but the side effects of treatment include cardiovascular morbidity and mortality,” said lead author Dr Iwan Harries, cardiology specialist registrar at Bristol Heart Institute, currently pursuing a PhD on cardiac magnetic resonance (CMR) imaging and cardio-oncology at the University of Bristol, UK.A 2016 European Society of Cardiology (ESC) position paper on cardio-oncology described female sex as a risk factor for developing cardiotoxicity from chemotherapy.2 Dr Harries said: “The data largely originates from paediatric populations and, in contrast, animal studies report male susceptibility to cardiomyopathy.” This retrospective observational study in adults investigated whether there was a sex effect on chemotherapy-induced cardiomyopathy. The researchers identified all patients over a six year period that received potentially cardiotoxic chemotherapy, were referred for CMR, and were found to have impaired left ventricular function (chemotherapy-induced cardiomyopathy). Patients were excluded if they had another condition that could have contributed to the cardiomyopathy such as ischaemic heart disease, valvular heart disease, family history of cardiomyopathy, or excess alcohol consumption. The study included 76 patients (45 women and 31 men). Data was collected on baseline demographics and comorbidities. Details of the cancer treatment were recorded, including the type of chemotherapy, dose of chemotherapy, and the interval between receiving treatment and having the CMR scan. CMR scans provided information on left and right ventricular function, cardiac volumes, and tissue characteristics.To assess the potential impact of gender on the development of chemotherapy-induced cardiomyopathy, the researchers conducted a multivariate regression analysis correcting for baseline differences between men and women including age, body surface area, comorbidities, and treatment.The researchers found that both left and right ventricular ejection fraction was significantly lower in men than women, indicating worse performance of the heart. Cardiac volumes and mass were significantly larger in men compared to women, indicating more damage to the heart’s structure. Dr Harries said: “The results of our study suggest that men developed a more severe form of chemotherapy-induced cardiomyopathy than women at follow-up of 8.75 years. Patients receiving anthracycline received on average 240 mg/m2 of doxorubicin or equivalent, a dose which was similar in both men and women.”
Previous studies in paediatric populations which found increased risk in females may be explained by the absence of female sex hormones early in life. In adults it may be that female sex hormones are protective. “Previous lab-based research has shown that female adult rat cardiac muscle cells have a survival advantage over male cells when challenged with oxidative stress-induced cell death3, which is one of the proposed mechanisms of chemotherapy-induced cardiomyopathy,” Dr Harries explained. Dr Harries said: “Ours is a preliminary result and large scale trials are needed to confirm our finding that men are more susceptible to chemotherapy-induced cardiomyopathy than women. If confirmed, the implication of these findings is that cardiologists and oncologists could devise individualised treatment and monitoring strategies for their patients that take gender into account.” “Cardio-oncology is a new field of cardiology that is rapidly developing thanks to oncology treatments being more efficacious and oncology patients living longer but with associated cardiovascular morbidity and mortality due to cardiotoxicity,” Dr Bucciarelli-Ducci, senior lecturer in cardiology at the University of Bristol and principal investigator of the study concluded.

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Peripartum cardiomyopathy occurs globally and is not a disease of the poor

Posted by fidest press agency su giovedì, 9 marzo 2017

cardiologiaSophia Antipolis. Peripartum cardiomyopathy (PPCM) occurs globally and is not a disease of the poor, according to research published today in the European Journal of Heart Failure. Cases were reported from many countries for the first time.“People have always thought PPCM was much more common and severe in Africans and that it was a disease of poverty but our study clearly shows that it’s not,” said lead author Professor Karen Sliwa, director of the Hatter Institute for Cardiovascular Research in Africa, Cape Town, South Africa. The study was conducted by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) Study Group on PPCM under the EURObservational Research Programme (EORP).PPCM is a structural heart muscle disease that occurs in women either at the end of pregnancy or up to five months after giving birth. Patients were previously healthy and then present with shortness of breath and heart failure.In about one-third of women with PPCM the heart muscle spontaneously recovers, but about 10% die from the disease and over half have a weakened heart muscle for the rest of their lives. The baby is sometimes born smaller and earlier, and in rare cases it dies.Research has shown that women with PPCM produce an abnormal breastfeeding hormone that leads to programmed cell death (apoptosis) and damage to the heart muscle.There is very little known about PPCM and until recently it was assumed that it occurred predominantly in African women. This registry study was conducted to find out whether PPCM occurs in other continents. Specifically, the researchers set out to discover how the disease presents, is diagnosed, and treated in different countries.The paper published today reports the baseline results of 411 patients from 43 countries representing all continents. Data collected included demographic characteristics, co-morbidities, treatments, type of hospital, and specialisation of the treating physician.The researchers found cases of PPCM in all 43 countries studied. All women with PPCM presented at the same age, and with the same symptoms and heart size, despite different ethnic backgrounds and huge disparities in socioeconomic factors and access to healthcare.“Our data shows that PPCM is truly a global disease, and irrespective of where you live, what healthcare system you have, what nutrition you have, and what education you have, you can get this disease,” said Professor Sliwa.“The disease presented quite uniformly despite occurring globally in different ethnic groups and in very different healthcare systems,” she continued. “This tells us that PPCM is to some extent a biological disease and women might have a genetic predisposition, which is probably a cellular and cardiac signalling abnormality. This is not a disease with marked differences between ethnic groups.”“We were surprised to see that there is a large percentage of women from the UK, for instance, and from Germany, countries which had not reported many cases so far,” added Professor Sliwa.
One month after diagnosis, 80% of the women with PPCM still had heart failure. About 7% of the women had blood clots – either a stroke, clot to the lung, or clot to the legs. “Despite good access to healthcare and good medical therapy, PPCM remains a very serious disease because many women remain in heart failure or develop blood clots,” said Professor Sliwa.“PPCM occurs in all health systems and is probably underdiagnosed in many parts of the world,” she continued. “More awareness needs to be created for this disease so that women can be given timely and appropriate treatment.”The registry aims to recruit 1,000 women with PPCM and will see if there are any differences in six month outcomes between ethnic groups.

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