Partially reversible bortezomib-induced cardiotoxicity: an unusual cause of acute cardiomyopathy

• Main Authors: Marcelle G. Meseeha, Victor O. Kolade, Maximos N. Attia
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2015-12-01
• Series: Journal of Community Hospital Internal Medicine Perspectives
• Subjects: bortezomib; proteasome inhibitors; cardiotoxicity; multiple myeloma; heart failure
• Online Access: http://www.jchimp.net/index.php/jchimp/article/view/28982/pdf_70

Chemotherapy-associated cardiotoxicity can present as a spectrum from arrhythmia to acute congestive heart failure. Unlike anthracyclines, proteasome inhibitors – for example, bortezomib – are not notorious for causing cardiotoxicity in absence of pre-existing cardiac dysfunction or without concomitant use of other cardiotoxic agents. We describe a 66-year-old woman with end-stage renal disease who developed acute dyspnea hours after a third treatment with bortezomib for IgG kappa myeloma. The Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 5) between bortezomib and acute left ventricular dysfunction. Patients receiving proteasome inhibitors should be closely monitored for evidence of cardiac dysfunction during treatment.