Development of Severe Heart Failure in a Patient with Squamous Non-small-cell Lung Cancer During Nivolumab Treatment
Yumiko Samejima, Atsuhiko Iuchi, Tomohiro Kanai, Yoshimi Noda, Shingo Nasu, Ayako Tanaka, Naoko Morishita, Hidekazu Suzuki, Norio Okamoto, Hiroshi Harada, Akira Ezumi, Kayo Ueda, Kunimitsu Kawahara, Tomonori Hirashima
Abstract
Cardiac side effects associated with immune checkpoint inhibitors (ICIs) are an uncommon but serious complication with a relatively high mortality. We experienced a case of cardiomyopathy induced by nivolumab. Echocardiography showed diffuse hypo-kinesis of the left ventricular cardiac wall and a significant decrease in the ejection fraction, like dilated cardiomyopathy. The myocardial biopsy showed non-inflammatory change; cardiac function gradually improved after treatment of acute heart failure without a corticosteroid. Although non-inflammatory left ventricular dysfunction induced by ICIs is rare, it is a reported cardiovascular toxicity. Physicians should consider this complication when treating patients with ICIs for malignant diseases.