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ORIGINAL ARTICLE
Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 211

Late cardiotoxicity in MS patients treated with mitoxantrone


1 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Neurology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Jamshid Najafian
Department of Cardiology, Isfahan Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpvm.IJPVM_477_17

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Context: Mitoxantrone (MTX) is an antracyclin drug that is used for treatment of patients with chronic refractory multiple sclerosis (MS). Congestive heart failure (CHF) is a rare complication of this drug that may occur early, during therapy, or late, months or years after termination of therapy. Aims: The aim of this study is to evaluate the long-term adverse effect of MTX on cardiac function. Methods: The study involved 49 MS patients on MTX therapy because of their disease was refractory to other treatments (18 men and 31 women). They were treated in two canters related to Esfahan University of Medical Sciences. The mean age was 34.65 ± 9.56 years. Systolic and diastolic left ventricular (LV) functions were measured by echocardiography. The baseline echocardiographic data were collected from patients' file. Echocardiography was repeated by a single cardiologist in 2016. Results: After MTX therapy, one patient's ejection fraction (EF) reduced below 50% (2%). In spite of their normal diastolic function before therapy, two patients developed diastolic dysfunction (4%). Nonparametric binominal analysis reveals that MTX therapy increased the probability of developing systolic dysfunction, early or late P < 001. Conclusions: MS patients treated with MTX are at increased risk of developing early and late-LV dysfunction, so all patients on MTX therapy must be periodically evaluated for these late complications.


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