Publications by authors named "Valeriano C Simbre II"

2 Publications

  • Page 1 of 1

Cardiomyocyte injury to transplant: pediatric management.

Curr Opin Cardiol 2003 Mar;18(2):91-7

Division of Pediatric Cardiology, Golisano Children's Hospital at Strong, University of Rochester School of Medicine and Dentistry, New York 14642, USA.

Cardiomyocyte injury in pediatric patients has a vast number of causes, which are often distinct from the causes of adult heart failure. However, the management of pediatric heart failure and heart transplantation has generally been inferred from adult studies. New therapies show great promise for the neurohormonal regulation of heart failure and the ability to control immunosuppression after heart transplantation. Large, randomized, multicenter, controlled clinical trials are needed to determine the efficacy of these therapies in this population. This article reviews the current recommendations and evidence-based medicine, where available, for the medical management of myopathic dysfunction and transplantation in pediatric patients.
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http://dx.doi.org/10.1097/00001573-200303000-00003DOI Listing
March 2003

Cardiomyopathy Caused by Antineoplastic Therapies.

Curr Treat Options Cardiovasc Med 2001 Dec;3(6):493-505

Divisions of Cardiology and Gastroenterology/Nutrition, Department of Pediatrics, and Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 631, Rochester, NY 14642, USA.

The goals of care for patients at risk for cardiomyopathy induced by cancer treatment should include prevention, early diagnosis, treatment of subclinical cardiac dysfunction, prevention of disease progression, and prolongation of patient survival. Any strategy aimed to minimize the cardiotoxic effects of cancer treatment should maintain the treatment's antineoplastic efficacy. Successful therapy achieves the highest health-related quality of life that is defined by the balance between maximizing the efficacy of oncologic therapy and minimizing the toxicity of this therapy. Doxorubicin-induced cardiotoxicity can be reduced by limiting the overall cumulative dose. There is no specific treatment for cancer therapy-related cardiomyopathy, and symptomatic patients should receive standard treatments for congestive heart failure such as afterload reduction, beta-blockers, diuresis, and digoxin. Afterload reduction with angiotensin-converting enzyme inhibitors such as enalapril and captopril may be indicated in patients with elevated afterload and asymptomatic left ventricular dysfunction diagnosed by echocardiography. Beta-blockers may improve myocardial systolic dysfunction and may be useful in the treatment of cancer treatment-induced cardiomyopathy. Cardiac transplantation remains a viable option in patients with cancer treatment-induced end-stage heart disease.
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http://dx.doi.org/10.1007/s11936-001-0023-8DOI Listing
December 2001