BACKGROUND: The main strategy for minimizing anthracycline cardiotoxicity is early detection of high-risk patients. AIM OF THE STUDY: To investigate the role of cardiac biomarkers; cardiac troponin T (cTnT) and N-terminal probrain natriuretic peptide (NT-pro-BNP), and tissue Doppler imaging (TDI), as early predictors of chronic cardiotoxicity in survivors of acute leukemia. PATIENTS AND METHODS: We carried a retrospective study on 50 asymptomatic survivors of acute leukemia who received anthracycline in their treatment protocols. All patients underwent blood sampling to determine the levels of NT-pro-BNP and cTnT along with conventional echocardiography and TDI. RESULTS: None had abnormal cTnT levels. About 20% had abnormal NT-pro-BNP levels. Diastolic dysfunction of the left ventricle was the most significant in conventional echocardiography. TDI was superior as it detected myocardial affection in 10% more than echo. TDI demonstrated global myocardial damage with significant aberrations in peak myocardial velocities and ratios. CONCLUSIONS: NT-pro-BNP can be used as a sensitive cardiac biomarker in monitoring of anthracycline-induced cardiotoxicity. Follow up is essential to validate the role of NT-pro-BNP as an early marker for late onset anthracycline-induced cardiotoxicity. Tissue Doppler is marvelous as it could detect early cardiac dysfunction even in those with normal study by conventional echocardiography.
BACKGROUND: The main strategy for minimizing anthracyclinecardiotoxicity is early detection of high-risk patients. AIM OF THE STUDY: To investigate the role of cardiac biomarkers; cardiac troponin T (cTnT) and N-terminal probrain natriuretic peptide (NT-pro-BNP), and tissue Doppler imaging (TDI), as early predictors of chronic cardiotoxicity in survivors of acute leukemia. PATIENTS AND METHODS: We carried a retrospective study on 50 asymptomatic survivors of acute leukemia who received anthracycline in their treatment protocols. All patients underwent blood sampling to determine the levels of NT-pro-BNP and cTnT along with conventional echocardiography and TDI. RESULTS: None had abnormal cTnT levels. About 20% had abnormal NT-pro-BNP levels. Diastolic dysfunction of the left ventricle was the most significant in conventional echocardiography. TDI was superior as it detected myocardial affection in 10% more than echo. TDI demonstrated global myocardial damage with significant aberrations in peak myocardial velocities and ratios. CONCLUSIONS:NT-pro-BNP can be used as a sensitive cardiac biomarker in monitoring of anthracycline-induced cardiotoxicity. Follow up is essential to validate the role of NT-pro-BNP as an early marker for late onset anthracycline-induced cardiotoxicity. Tissue Doppler is marvelous as it could detect early cardiac dysfunction even in those with normal study by conventional echocardiography.
Authors: Saro H Armenian; Melissa M Hudson; Renee L Mulder; Ming Hui Chen; Louis S Constine; Mary Dwyer; Paul C Nathan; Wim J E Tissing; Sadhna Shankar; Elske Sieswerda; Rod Skinner; Julia Steinberger; Elvira C van Dalen; Helena van der Pal; W Hamish Wallace; Gill Levitt; Leontien C M Kremer Journal: Lancet Oncol Date: 2015-03 Impact factor: 41.316
Authors: Eric J Chow; Kasey J Leger; Neel S Bhatt; Daniel A Mulrooney; Colin J Ross; Sanjeev Aggarwal; Neha Bansal; Matthew J Ehrhardt; Saro H Armenian; Jessica M Scott; Borah Hong Journal: Cardiovasc Res Date: 2019-04-15 Impact factor: 10.787
Authors: Carrie A Geisberg; Wissam M Abdallah; Monica da Silva; Cheri Silverstein; Holly M Smith; Vandana Abramson; Ingrid Mayer; Julie Means-Powell; Darla Freehardt; Brenda White; Daniel Lenihan; Douglas B Sawyer Journal: J Card Fail Date: 2013-01 Impact factor: 5.712