Serum troponin T levels and echocardiographic evaluation in children treated with doxorubicin

Kısmet, Erol; Varan, Ali; Ayabakan, Canan; Alehan, Dursun; Portakal, Oytun; Büyükpamukçu, Münevver

doi:10.1002/pbc.10368

Cited by 65 publications

(49 citation statements)

References 19 publications

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“…The clinical value of cTn and NPs measurement in diagnosis of heart failure during and after the anticancer treatment has been evaluated in several studies with adults and children [7,9,13,14,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…Currently there is no optimal method that can be used for early detection of subclinical late cardiotoxicity. The role of biochemical cardiomarkers that reflect cardiomyocyte degeneration (serum levels of cTnT) and functional myocardial changes (serum levels of NT-proBNP) in early detection of cardiotoxicity of cytostatics have been evaluated in many clinical and experimental studies [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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Long-term cardiac effects of treatment for childhood leukemia

Urbanová

Urbán²,

Šimková³

et al. 2010

neo

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Late cardiac complications in cancer survivors may develop from subclinical myocardial damage. Biochemical correlates of minimal myocardial changes can be analyzed using a commercially available rapid assay. Biomarkers are considered more sensitive markers of subclinical cardiotoxicity than conventional electrocardiographic and echocardiographic methods.The aim of this study was to determine the values of plasma N-terminal pro brain natriuretic peptide (NT-pro-BNP) and cardiac troponin T (cTnT) in asymptomatic childhood leukemia survivors after anthracycline therapy in comparison with healthy volunteers. The survivors also underwent a detailed echocardiography.Twenty six survivors of leukemia previously treated with anthracyclines with total cumulative dose 95-600 (median 221) mg/m 2 were evaluated. Analyses of cTnT and NT-proBNP from blood samples and echocardiography were performed 5-25 years after completion of therapy for childhood leukemia. Control group for biochemical analyses consisted of 22 age-and gender-matched apparently healthy volunteers.Values of NT-proBNP were significantly elevated in ANT group compared to controls (35.1 ± 37.8 vs. 9.6 ± 6.7 pg/ml, P<0.010). CTnT remained below the diagnostic cut-off values in both groups. All echocardiographic parameters of patients remained normal.In conclusion, differences in NT-proBNP values between patients treated with anthracyclines and healthy volunteers might signal an initial stage of anthracycline-induced myocardial damage. The potential of this biomarker to detect subclinical anthracycline-induced myocardial alterations before development of echocardiographic and clinical changes is promising. Key words: cardiotoxicity, natriuretic peptides, cardiac troponins, anthracyclines, echocardiographyNeoplasma 57, 2, 2010 doi:10.4149/neo_2010_02_179Abbreviations: ANT group -patients previously treated with anthracyclines; cTn -cardiac troponins; cTnT -cardiac troponinT; NPs -natriuretic peptides; NT-proBNP -N-terminal fragment of the brain natriuretic peptide precursor; LV -left ventricular; LVEDD -left ventricular end-diastolic diameter; LVESD -left ventricular end-systolic diameter; LA -left atrium dimension; RV -right ventricular dimension; EF -ejection fraction; E -early diastolic flow velocity; A -late diastolic flow velocity; DT -deceleration time; IVRT -left ventricular isovolumetric relaxation time; TDI -tissue Doppler imaging; Ea -early diastolic velocity of the medial mitral annulus; Em; Sa -systolic velocity; Am -late diastolic velocity

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term cardiac effects of treatment for childhood leukemia

Urbanová

Urbán²,

Šimková³

et al. 2010

neo

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“…In addition, an increase in Tn-I was associated with a 17.6 times increased risk of cardiotoxicity, and emerged as the only independent predictor of lack of recovery in LVEF despite treatment with HF therapy, which consisted of enalapril and carvedilol upbeing titrated to maximally tolerated doses used in conventional HF [48]. However, these results still need to be confirmed [49][50][51]. High-sensitive troponins assays may have a greater interest for the detection of subclinical myocardial damage.…”

Section: Circulating Biomarkersmentioning

confidence: 99%

Cardiac Imaging: Multimodality Advances and Surveillance Strategies in Detection of Cardiotoxicity

2017

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Contemporary cancer management has increased the overall number of cancer survivors, but cardiotoxicity remains a subject of concern, which is a major cause of noncancer mortality among survivors. Among the potential cardiovascular complications, left ventricular (LV) systolic dysfunction is a poor prognostic factor. The importance of its early detection is based on the principle that the likelihood of response to heart failure (HF) treatment is temporally related to the initiation of HF treatment. For these reasons, cardiac monitoring is commonly applied in general practice, based on serial measurements of LV ejection fraction (LVEF); transthoracic echocardiography (TTE) is generally used. However, the LVEF, as a diagnostic and predictive parameter, has significant limitations, which calls for more effective multimodality imaging strategies. This approach requires further study, but there is increasing available data in the literature, encouraging the combination of multimodality imaging parameters and techniques for early cancer therapeutic-related cardiac dysfunction (CTRCD) detection.

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“…They proposed that determining serum levels of cTnT is a sensitive means for assessing the early cardiotoxicity of DOX. 33 However, Kismet et al 34 found no correlation between serum cTnT levels and cumulative DOX levels in 24 patients treated with DOX. In addition, they showed no correlation between serum cTnT levels and ECHO detected systolic and diastolic findings.…”

Section: Duxorubicinmentioning

confidence: 99%

“…Generally speaking, cardiotoxicity with cumulative doses above 450 mg/m 2 is a well-known adverse effect of DOX. 34 Lipshultz et al reported no elevation of serum cTnT levels after discontinuation of anthracycline therapy, but the cumulative DOX doses of their patients were below 222 mg/m 2 and the number of the patients was very few. They found a low level serum cTnT elevations in patients continuing their DOX therapies and suggested that these low-level elevations may persist for a time as an indicator of chronic inflammatory changes.…”

Section: Duxorubicinmentioning

confidence: 99%