Usefulness of myocardial performance index and biochemical markers for early detection of anthracycline-induced cardiotoxicity in adults

Dodos, Fotiní; Halbsguth, Teresa; Erdmann, Erland; Hoppe, Uta C.

doi:10.1007/s00392-007-0633-6

Cited by 151 publications

(113 citation statements)

References 43 publications

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“…183 In contrast, a study of 100 patients demonstrated transient increases in NT-proBNP in 13 patients treated with anthracycline chemotherapy but no association with LV systolic or diastolic function. 184 Other small studies have also demonstrated a lack of association 113,160,185,186 or only cross-sectional associations between BNP and LV diastolic function. 187 A larger scale study, the Effectiveness of Using Biomarkers to Detect and Identify Cardiotoxicity and Describe Treatment trial, 188 is currently under way, aiming to comprehensively determine the role of point-of-care biomarker testing in predicting cardiotoxicity in patients being treated with anthracyclines.…”

Section: Other Biomarkersmentioning

confidence: 99%

Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Plana

Galderisi

Barac

et al. 2014

Journal of the American Society of Echocardiography

1,295

1,209

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Section: Other Biomarkersmentioning

confidence: 99%

Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Plana

Galderisi

Barac

et al. 2014

Journal of the American Society of Echocardiography

1,295

1,209

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“…[66][67][68] While an increase in pro-BNP has been reported early after anthracycline administration, elevated pro-BNP has been found not to be predictive of future LV dysfunction. Pharmacogenomics has recently emerged as a potential biomarker of chemotherapy-induced cardiac dysfunction.…”

Section: Biomarkersmentioning

confidence: 99%

“…While they are inexpensive and readily available, no consensus on the role of biomarkers for prediction of anthracycline cardiotoxicity in adults has emerged. [66][67][68][69] The role of biomarkers is being currently evaluated in the multicenter NIH funded PREDICT study. 70 Biomarkers in 2013 remain of great promise and investigative interest.…”

Section: Biomarkersmentioning

confidence: 99%

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Schwartz

Jain

Storozynsky

2013

Journal of Nuclear Cardiology

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The field of cardio-oncology is challenged to address an ever greater spectrum of cardiotoxicity associated with combination chemotherapy, greater dose intensity, extremes of age, and enhanced patient survival which exposes more protracted risk of developing congestive heart failure (CHF). Recent reports of chemotherapy-induced hypertension as a common adverse effect of angiogenesis inhibitors and immunosuppressants clarify the need for routine blood pressure (BP) monitoring and guideline-based management of hypertension as an integral strategy to preserve LV function. Serial monitoring of radionuclide left ventricular ejection fraction (LVEF) in adults and echocardiography in children continues to provide outcome based, cost-effective prevention of CHF in high risk patients receiving chemotherapy. To optimize treatment and monitoring strategies to eliminate late-onset LV dysfunction and CHF, traditional and novel candidate methods for assessment of chemotherapy-induced LV dysfunction are reviewed. These include serial assessment of LV volume indices by gated SPECT ERNA and gated SPECT MPI, 3D echocardiography and contrast 2D echocardiography; longitudinal strain imaging, diastolic functional parameters, 123 I-MIBG, 111 In-Antimyosin antibody imaging, and 99m Tc-Annexin V apoptosis imaging, biomarkers including troponins and BNP; genetic markers, and both functional and tissue characterization techniques with T1 weighted and T2 weighted images with cardiac magnetic resonance imaging (CMR). In our quest to optimize strategies for long-term cancer survival and prevention of CHF for patients receiving chemotherapy, rigorous modality and guideline-specific clinical outcome trials are required. A new multi-modality monitoring approach is proposed, which integrates evidencebased strengths of CMR, echocardiography, ERNA, biomarkers, and BP management for surveillance and validation of cardiotoxicity and prevention of clinical heart failure in patients receiving a broad spectrum of cancer therapies.

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“…30 In patients treated with trastuzumab, a decrease in global longitudinal and radial strain but not LVEF was observed as early as three months in patients who later developed cardiotoxicity. 31 In a study of breast cancer patients treated with anthracyclines, systolic dysfunction could be detected with strain imaging within seven days of completing anthracyclines without similar change in LVEF. Furthermore, findings…”

Section: Radiationmentioning

confidence: 99%

“…28 Other studies with natriuretic peptide have not shown similar promise. [29][30][31] Abnormal high-sensitivity C-reactive protein (hs-CRP) was predictive of LVEF decline in breast cancer patients treated with trastuzumab. 32 …”

Section: Biomarkersmentioning

confidence: 99%

Cancer and Heart Failure: Understanding the Intersection

Hamo

Bloom

2017

Cardiac Failure Review

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Heart disease and cancer are the two leading causes of death, together accounting for almost 50 % of deaths in the US.1 Unfortunately, the tremendous success in improving cancer survival is often attenuated by downstream cardiovascular complications from cancer therapy.Acute cardiac toxicity may limit the ability to use life-saving cancer therapy and chronic toxicity limits overall survival. As novel agents with more specific targets become available, unanticipated cardiac complications arise. The spectrum of cardiac toxicities is broad, ranging from ischaemia and arrhythmias to hypertension, left ventricular dysfunction (LVD) and the development of clinical heart failure (HF).Notably, there is increasing evidence that suggests an underlying relationship between cancer and the heart, independent of cancer therapies' effect on left ventricular ejection fraction (LVEF) and heart rate. 2,3 HF caused by chemotherapy portends a worse prognosis compared with idiopathic and ischaemic cardiomyopathy, 4 highlighting the need for enhanced understanding and management. Definitions of Cancer Therapy-related Cardiac ToxicityThere is currently no universally accepted definition of cancer therapyrelated cardiac toxicity; however, several definitions pertaining to specific agents have been proposed. A recent consensus defines cancer therapy-related cardiac dysfunction (CTRCD) as a decrease in LVEF of >10 % to a value of <53 %. 5 The Cardiac Review and EvaluationCommittee involved in trials with trastuzumab defines cardiotoxicity as a decrease in LVEF that is either global or more severe in the septum and decline in LVEF of at least 5 % to <55 % with signs or symptoms of HF, or a decline of at least 10 % to <55 % without HF signs or symptoms. 6According to the Food and Drug Administration, anthracycline cardiotoxicity is defined as a >20 % decrease in LVEF when the baseline LVEF is normal, or >10 % decrease when baseline LVEF is abnormal. In contrast to topoisomerase II-alpha, which is located on rapidly dividing cells, topoisomerase II-beta, located on cardiac myocytes is the proposed mechanism behind the cardiotoxicity. 9 Anthracycline use has been shown to result in LVD with an incidence of 1-5 %, ranging from acute to late onset. 10 Anthracycline-induced HF is thought to be cumulative and dose-dependent, with an incidence reaching 5 % at a total doxorubicin dose of 450 mg/m 2 . 11 However, examination of endomyocardial biopsies reveals histopathological changes with doses as low as 240 mg/m 2 , suggesting that subclinical cardiotoxity may be present as early as the first dose. 12 HER2-targeted AgentsTrastuzumab, a monoclonal antibody targeted against humanised epidermal growth factor receptor 2 (HER2) has played a pivotal role in breast cancer patients whose tumours overexpress HER2. Under normal circumstances, in cardiac myocytes, the HER2 signalling pathway is responsible for adaptation to stress. 8 The incidence of LVD with trastuzumab ranges from 2 % to 28 %, 10 with a 1.7-4.1 % incidence of HF. 13 Other HER2-targeted a...

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Usefulness of myocardial performance index and biochemical markers for early detection of anthracycline-induced cardiotoxicity in adults

Cited by 151 publications

References 43 publications

Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Cancer and Heart Failure: Understanding the Intersection

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