Kinetics of B-type natriuretic peptide plasma levels in patients with left-sided breast cancer treated with radiation therapy: Results after one-year follow-up

D’Errico, Maria Patrizia; Petruzzelli, Maria Fonte; Gianicolo, Emilio; Grimaldi, Luca; Loliva, F.; Tramacere, Francesco; Andreassi, Maria Grazia; Pili, Giorgio; Picaño, Eugenio; Portaluri, Maurizio

doi:10.3109/09553002.2015.1027421

Cited by 24 publications

(14 citation statements)

References 28 publications

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“…Increased BNP levels were not associated with manifest or subclinical signs for LV dysfunction or onset of CAD. BNP levels were, however, related to the radiation doses (88,89).…”

Section: Cad and Acsmentioning

confidence: 84%

Biomarkers for the detection of apparent and subclinical cancer therapy-related cardiotoxicity

Michel¹,

Rassaf²,

Totzeck³

2018

J. Thorac. Dis

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Progress in cancer therapy over the past decades improved long-term survival but increased cancer therapy-related cardiotoxicity. Many novel treatment options have been implemented with yet incompletely characterized cardiovascular side effects including heart failure, coronary artery disease, arrhythmias, valvular disease, venous thromboembolism and myocarditis. Diagnosis of potential cardiotoxic side effects is essential for an optimal treatment but remains challenging. Cardiac biomarkers troponin and brain natriuretic peptide/N-terminal proBNP (BNP/NT-proBNP) have been extensively studied in heart failure and acute coronary syndromes. Emerging evidence implicates a significant role in the detection of cardiotoxicity and guidance of therapy in cancer patients. Elevated troponin or BNP/NT-proBNP levels were associated with increased all-cause mortality in cancer patients and have been shown to predict manifest heart failure. BNP/NT-proBNP may be useful for the prediction of cancer therapy-related heart failure and response to heart failure therapy in adult and pediatric cancer patients while troponin can indicate acute myocardial infarction in patients with cancer therapy-related risk for coronary artery disease. Furthermore, troponin may be used for the identification of immune checkpoint inhibitor-related myocarditis with very high sensitivity. Finally, even D-dimer levels have been shown to improve risk stratification and diagnosis in cancer-associated venous thromboembolism. This review aims to summarize the current knowledge about biomarkers in cancer therapy-related cardiotoxicity. We also outline possible clinical recommendations for the detection and treatment of subclinical and clinically apparent cardiotoxic effects using biomarkers.

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“…Increased BNP levels were not associated with manifest or subclinical signs for LV dysfunction or onset of CAD. BNP levels were, however, related to the radiation doses (88,89).…”

Section: Cad and Acsmentioning

confidence: 84%

Biomarkers for the detection of apparent and subclinical cancer therapy-related cardiotoxicity

Michel¹,

Rassaf²,

Totzeck³

2018

J. Thorac. Dis

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“…While RT potentially leads to accelerated late atherosclerosis, it potentially also leads to early microvascular changes which may manifest as early cardiac perfusion defects. 27,[33][34][35][36][37] Moreover, prior studies found that higher ventricular doses associated with increased troponin levels 38 , increased B-type natriuretic peptide levels 39 , and impaired LV ejection fraction. 40 Although we found weak associations between ACS/CHF events and mean LA and RA dose, these associations might be expected given the multicollinearity between ventricular and atrial doses (Spearman's r ¼ 0.75, p < 0.0001 between mean LV dose and mean LA dose), and were not significant after adjusting for multiple comparisons.…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Predictors of Symptomatic Cardiac Events After Conventional-Dose Chemoradiation Therapy for Inoperable NSCLC

Yegya-Raman

Wang

Kim

et al. 2018

Journal of Thoracic Oncology

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“…RT-associated ischemic heart disease is thought to result from accelerated late atherosclerosis and early microvascular damage manifesting as perfusion deficits, 34–37 and there are also reports linking LV dose to troponin and BNP elevation. 38,39 In a recent analysis of over 900 patients with breast cancer treated with radiation, van den Bogaard et al reported that LV dose had the greatest association with ischemic events. 10 Thus, the common perception that acute coronary syndrome is related to LV dose may also apply to patients with lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Heart dosimetric analysis of three types of cardiac toxicity in patients treated on dose-escalation trials for Stage III non-small-cell lung cancer

Wang

Pearlstein

Patchett

et al. 2017

Radiotherapy and Oncology

109

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Background and Purpose To assess associations between radiation dose/volume parameters for cardiac subvolumes and different types of cardiac events in patients treated on radiation dose-escalation trials. Material and Methods Patients with Stage III non-small-cell lung cancer received dose-escalated radiation (median 74 Gy) using 3D-conformal radiotherapy on six prospective trials from 1996–2009. Volumes analyzed included whole heart, left ventricle (LV), right atrium (RA), and left atrium (LA). Cardiac events were divided into three categories: pericardial (symptomatic effusion and pericarditis), ischemia (myocardial infarction and unstable angina), and arrhythmia. Univariable competing risks analysis was used. Results 112 patients were analyzed, with median follow-up 8.8 years for surviving patients. Nine patients had pericardial, seven patients had ischemic, and 12 patients had arrhythmic events. Pericardial events were correlated with whole heart, RA, and LA dose (eg, heart-V30 [p=0.024], RA-V30 [p=0.013], and LA-V30 [p=0.001]), but not LV dose. Ischemic events were correlated with LV and whole heart dose (eg, LV-V30 [p=0.012], heart-V30 [p=0.048]). Arrhythmic events showed borderline significant associations with RA, LA, and whole heart dose (eg, RA-V30 [p=0.082], LA-V30 [p=0.076], heart-V30 [p=0.051]). Cardiac events were associated with decreased survival on univariable analysis (p=0.008, HR 2.09), but only disease progression predicted for decreased survival on multivariable analysis. Conclusions Cardiac events were heterogeneous and associated with distinct heart subvolume doses. These data support the hypothesis of distinct etiologies for different types of radiation-associated cardiotoxicity.

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Kinetics of B-type natriuretic peptide plasma levels in patients with left-sided breast cancer treated with radiation therapy: Results after one-year follow-up

Abstract: BNP plasma levels could provide additional information about subclinical RT-induced cardiotoxicity earlier than traditional ecocardiographic data.

Cited by 24 publications

References 28 publications

Biomarkers for the detection of apparent and subclinical cancer therapy-related cardiotoxicity

Biomarkers for the detection of apparent and subclinical cancer therapy-related cardiotoxicity

Dosimetric Predictors of Symptomatic Cardiac Events After Conventional-Dose Chemoradiation Therapy for Inoperable NSCLC

Heart dosimetric analysis of three types of cardiac toxicity in patients treated on dose-escalation trials for Stage III non-small-cell lung cancer

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