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has been cited by the following article:

• TITLE: Cardiac Toxicity of Azole Antifungals

  AUTHORS: John D. Cleary, Kayla R. Stover, Jerry Farley, William Daley, Patrick B. Kyle, Jon Hosler

  KEYWORDS: Mycology; Azole Antifungals; Itraconazole; Animal Model

  JOURNAL NAME: Pharmacology & Pharmacy, Vol.4 No.3, June 20, 2013

  ABSTRACT: Cardiac toxicity is an uncommon side effect of anti-fungal therapy. Until the recent reports of itraconazole (ITZ) associated cardiac failure, amphotericin was the antifungal most frequently reported with arrhythmias. We evaluated the cardiac effect of azole antifungals, specifically ITZ, and possible mechanisms of toxicity. Ex vivo live-heart studies were performed utilizing Sprague Dawley rats. Short exposure (25 (2 - 2.5 ug/mL) exposures, contractility decreased by 22.2% ± 15.7% and amplitude of left ventricular pressure decreased by 11% ± 0.17%. Electron micrograph and alterations in mitochondrial respiration suggest mitochondrial toxicity as an underlying mechanism. In conclusion, ITZ was associated with reductions in contractility, possibly secondary to mitochondrial dysfunction and dilated cardiomyopathy.