Relationship between Chemotherapy and Atrial Fibrillation: Clinical Case

The aim of this article is to represent the characterization of the clinical case of chemotherapy-related atrial fibrillation (AF) development in the young woman, elaborated as a result of multiple neoadjuvant and adjuvant modes of the intake of chemotherapy (both anthracycline based and non-anthracycline ones). In this case, the noted disturbances of heart rhythm should be recognized as a manifestation of cardiotoxicity. The latter implies the degree of detrimental effect of chemotherapeutical medication on the morphophynctional parameters of the cardiovascular system. Anthracycline drugs, being highly effective chemotherapytical agents, provide well-known toxic effects on the heart and vessels. Anthracycline mediated cardiotoxicity is a well- known veracity that dates back to the 60s of the last century, but up to now this medication sustains irreplaceable components of big volume of chemotherapy modes. Moreover, it should be noted that relatively newer drugs also posses certain cardiotoxicogenic potential

СОПУТСТВУЮЩИЕ ЗАБОЛЕВАНИЯ И ФАКТОРЫ РИСКА ИХ РАЗВИТИЯ У БОЛЬНЫХ ВИЧ-ИНФЕКЦИЕЙ СТАРШЕ 40 ЛЕТ

Objective: Evaluation of CVD and their risk factors in Russian 40+ HIV-infected patients is a key objective of the study. Materials and Methods: A retrospective analysis of 1872 medical records of 40+ HIV-infected patients from 12 regions of Russia on HAART was performed, including assessment of CVD presence, their risk factors and 10-years CVD risk based on SCORE. All patients received ARV treatment; the average duration of admission was 5 years (1–2 years – 43%, 3–5 years – 29%, over 5 years – 28%). Results: High incidence of CVD was observed: hypertension – 48%, including cerebrovascular disease – 2%; CAD – 9%, including myocardial infarction – 6%. Analysis of cardiovascular risk factors showed that 19% were overweight, lipid metabolism disorders were detected in 30% of patients, diabetes in 5%. 51% of patients smoked, systematic intake of alcohol in 61% of patients. 69% of patients had a risk of fatal CVD within 10 years based on SCORE, 16% of patients had a high/very high risk. Analysis of metabolic parameters showed that 99,4% of patients needed lifestyle improvement measures, 85% needed lipid lowering medication. One third of patients were constantly taking cardiovascular medications. Conclusions: CVD and metabolic disorders are more common for 40+ HIV-infected patients than for general population. ART assessment in 40+ patients additionally to viral load and CD4 level, should include analysis of cardiovascular risk factors and comorbidities. In elder patients ART regimen choice is particularly important, considering the risks of development and/or progression of CVD and risk of drugdrug interactions development.Цель: оценка сопутствующих заболеваний (ССЗ) и факторов риска их развития в российской популяции ВИЧ-инфицированных пациентов старше 40 лет. Материалы и методы: выполнен ретроспективный анализ карт 1872 ВИЧ-инфицированных пациентов старше 40 лет из 12 регионов России, включая оценку ССЗ, факторов риска их развития и 10-летний риск ССЗ по шкале SCORE. Все пациенты получали АРТ; средняя продолжительность терапии составила 5 лет (1–2 года – 43%, 3–5 лет – 29%, более 5 лет – 28%). Результаты: наблюдалась высокая частота ССЗ: артериальная гипертензия – 48%, включая нарушения мозгового кровообращения – 2%; ИБС – 9%, включая инфакрт миокарда – 6%. Анализ сердечно-сосудистых факторов риска показал ожирение у 19% пациентов, нарушения липидного обмена у 30% пациентов, сахарный диабет у 5%. Курение было отмечено у 51% пациентов, систематическое употребление алкоголя у 61%. 69% имели риск смертельного ССЗ в течение 10 лет по шкале SCORE, у 16% пациентов наблюдался высокий/очень высокий риск. Анализ нарушений метаболизма показал, что 99,4% пациентов нуждаются в различных мерах по изменению образа жизни, 85% нуждаются в гиполипидемической терапии. Одна треть пациентов постоянно получали сердечно-сосудистую терапию. Заключение: в группе больных ВИЧ-инфекцией старше 40 лет чаще выявляются заболевания сердечно-сосудистой системы, нарушение обмена веществ, по сравнению с общей популяцией. Анализ эффективности антиретровирусной терапии (АРТ) пациентов старше 40 лет дополнительно к вирусной нагрузке и уровню CD4 клеток должен включать анализ сердечно-сосудистых факторов риска и сопутствующих заболеваний. Для пациентов старшего возраста выбор режима АРТ особенно важен, учитывая риск развития и/или прогрессирования ССЗ и риск возникновения лекарственных взаимодействий

Chemotherapy as a possible trigger for the myocardial lipomatosis development

Abstract This article presents a clinical case of an asymptomatic myocardial damage associated with the chemotherapy. Myocardial lipomatosis developed in a 23-year-old patient with cancer of the right breast after 4 AC chemotherapy cycles. The death resulted from the rupture of a 14 cm saccular aneurysm of the internal carotid artery. This article presents both the data of instrumental and laboratory tests and pathomorphological analysi

CONCOMITANT DISEASES AND RISK FACTORS FOR THEIR DEVELOPMENT IN PATIENTS WITH HIV INFECTION OLDER THAN 40 YEARS

Objective: Evaluation of CVD and their risk factors in Russian 40+ HIV-infected patients is a key objective of the study. Materials and Methods: A retrospective analysis of 1872 medical records of 40+ HIV-infected patients from 12 regions of Russia on HAART was performed, including assessment of CVD presence, their risk factors and 10-years CVD risk based on SCORE. All patients received ARV treatment; the average duration of admission was 5 years (1–2 years – 43%, 3–5 years – 29%, over 5 years – 28%). Results: High incidence of CVD was observed: hypertension – 48%, including cerebrovascular disease – 2%; CAD – 9%, including myocardial infarction – 6%. Analysis of cardiovascular risk factors showed that 19% were overweight, lipid metabolism disorders were detected in 30% of patients, diabetes in 5%. 51% of patients smoked, systematic intake of alcohol in 61% of patients. 69% of patients had a risk of fatal CVD within 10 years based on SCORE, 16% of patients had a high/very high risk. Analysis of metabolic parameters showed that 99,4% of patients needed lifestyle improvement measures, 85% needed lipid lowering medication. One third of patients were constantly taking cardiovascular medications. Conclusions: CVD and metabolic disorders are more common for 40+ HIV-infected patients than for general population. ART assessment in 40+ patients additionally to viral load and CD4 level, should include analysis of cardiovascular risk factors and comorbidities. In elder patients ART regimen choice is particularly important, considering the risks of development and/or progression of CVD and risk of drugdrug interactions development