From the Guidelines
Drug-induced cardiomyopathy is called anthracycline-induced cardiomyopathy.
Key Characteristics
- This condition is characterized by changes in myocyte morphology that indicate nonischemic cellular degeneration 1.
- It is caused by anthracyclines, a class of chemotherapeutic drugs, which can lead to cardiotoxicity through various mechanisms, including the generation of reactive oxygen species and disruption of cell membranes and mitochondria 1.
- The prognosis of anthracycline-induced cardiomyopathy relates to the time course of treatment and preexisting additional risk factors for myocardial injury, such as radiation, coexisting CAD, and preexisting cardiac dysfunction 1.
Diagnosis and Monitoring
- Cardiac troponin levels combined with longitudinal strain measured by echocardiography appear to provide better prediction for development of cardiotoxicity than other biomarkers or imaging alone 1.
- Endomyocardial biopsy (EMB) is recognized as the most sensitive diagnostic tool to detect anthracycline-induced cardiomyopathy, although it is not performed routinely 1.
Risk Factors
- Higher lifetime cumulative anthracycline dose, concurrent or prior cardiac irradiation, concomitant administration of other cardiotoxic chemotherapeutic agents, pre-existing cardiovascular disease, and comorbidities are known risk factors for anthracycline-induced cardiomyopathy 1.
- Genetic variants associated with anthracycline-induced cardiomyopathy have been identified, and genetic testing may be useful in predicting risk and guiding treatment decisions 1.
From the Research
Definition of Drug-Induced Cardiomyopathy
Drug-induced cardiomyopathy is a condition where the heart muscle is damaged due to the use of certain medications. This condition can lead to heart failure, which is a clinical syndrome characterized by the heart's inability to pump enough blood to meet the body's needs.
Types of Drug-Induced Cardiomyopathy
- Anthracycline-induced cardiomyopathy, which is caused by the use of anticancer drugs such as doxorubicin and daunorubicin 2
- Toxic cardiomyopathy, which can be caused by a variety of drugs, including anticancer drugs, antiretroviral agents, antidiabetic drugs, and illicit substances 3
- Drug-induced Takotsubo cardiomyopathy, which is a type of stress cardiomyopathy that can be triggered by certain medications 4
Mechanisms of Drug-Induced Cardiomyopathy
- Interference with myocardial cell bioenergetics and intracellular calcium handling 3
- Generation of reactive oxygen species (ROS) 3
- Neurohormonal stress 3
- Induction of apoptosis 3