Cardiac biomarkers indicate a need for sensitive cardiac imaging among long-term childhood cancer survivors exposed to anthracyclines

Ylänen, Kaisa; Poutanen, Tuija; Savukoski, Tanja; Eerola, Anneli; Vettenranta, Kim

doi:10.1111/apa.12862

Cited by 15 publications

(12 citation statements)

References 29 publications

(38 reference statements)

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“…LV dysfunction was present in 0%–37% of the study populations with one study having no patients with LV dysfunction 28. Cut-off values for NT-proBNP levels varied from 63 ng/L in males and 116 ng/L in females29 to 125 ng/L in males and females 15. Cut-off values for children were defined in the studies as age-specific and sex-specific values previously reported by Nir et al 29 31 32 and Albers et al 13 33.…”

Section: Resultsmentioning

confidence: 99%

Biomarkers to diagnose ventricular dysfunction in childhood cancer survivors: a systematic review

Leerink

Verkleij

Feijen

et al. 2018

Heart

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Section: Resultsmentioning

confidence: 99%

Biomarkers to diagnose ventricular dysfunction in childhood cancer survivors: a systematic review

Leerink

Verkleij

Feijen

et al. 2018

Heart

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“…On the contrary, NT-pro-BNP, marker of high filling pressures, has a controversial role in early detection of cardiac dysfunction 2 . Several studies demonstrated the role of troponin I and NT-pro-BNP in assessing cardiac dysfunction in hematological neoplasia treated with anthracyclines 7 , however, other studies failed to show contribution of these biomarkers for early detection of cardiotoxicity 24 . In our study, troponin I increased early, while 3D LVEF maintained within normal ranges, persistent after CHOP completion treatment, and significantly higher in group who developed cardiotoxicity.…”

Section: Discussionmentioning

confidence: 99%

3D echocardiography, arterial stiffness, and biomarkers in early diagnosis and prediction of CHOP-induced cardiotoxicity in non-Hodgkin’s lymphoma

Mihalcea

Florescu

Bruja

et al. 2020

Sci Rep

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CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) represents standard chemotherapy in non-Hodgkin's lymphoma (NHL) with risk of cardiotoxicity. To define new parameters, such as 3D myocardial deformation, arterial stiffness, and biomarkers for early diagnosis and prediction of cardiotoxicity. 110 NHL patients with LVEF > 50%, scheduled for CHOP, were evaluated at baseline, after third cycle and chemotherapy completion. 3DE assessed LVEF and myocardial deformation: longitudinal (LS), radial, circumferential, area strain. Echo-tracking analysed arterial stiffness: PWV, β index, wave intensity. Troponin I and NT-pro-BNP were measured. After chemotherapy completion, 18 patients (16%) (group I) developed cardiotoxicity (LVEF decrease < 50%, with > 10% from baseline); 92 patients (group II) did not. Significant reduction of 3D LV deformation and increase of arterial stiffness developed starting with third cycle, with greater changes in group I. LS reduction and PWV increase after third cycle were the best independent predictors for LVEF decrease; the association of LS decrease by > 19% and PWV increase by > 27% after third cycle predicted cardiotoxicity after chemotherapy completion (90% sensitivity and 81% specificity). 3D LS and PWV can detect early chemotherapy-induced cardiotoxicity and predict LVEF decline. These parameters should be incorporated in clinical protocols to monitor cardiovascular function during chemotherapy and early intervention.

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“…Both studies, hence, validate the importance of using conventional troponin for surveillance post-chemotherapy as both a sensitive and reproducible marker of myocardial dysfunction, prior to development of HF. There is also increasing data emerging from survivors of childhood cancers which shows that cTnI and hs-TnI were not consistently elevated in patients who developed LV dysfunction on imaging [ 68 – 70 ]. Hence, these studies demonstrate that although troponin is a sensitive marker during and early after chemotherapy, it is not a sensitive marker for ongoing surveillance of subclinical cardiotoxicity post-chemotherapy, when compared to other biomarkers such as NPs.…”

Section: Cardiac Troponinmentioning

confidence: 99%

The Role of Biomarkers in Cardio-Oncology

Ananthan

Lyon

2020

J. of Cardiovasc. Trans. Res.

113

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In the field of cardio-oncology, it is well recognised that despite the benefits of chemotherapy in treating and possibly curing cancer, it can cause catastrophic damage to bystander tissues resulting in a range of potentially of life-threatening cardiovascular toxicities, and leading to a number of damaging side effects including heart failure and myocardial infarction. Cardiotoxicity is responsible for significant morbidity and mortality in the long-term in oncology patients, specifically due to left ventricular dysfunction. There is increasing emphasis on the early use of biomarkers in order to detect the cardiotoxicity at a stage before it becomes irreversible. The most important markers of cardiac injury are cardiac troponin and natriuretic peptides, whilst markers of inflammation such as interleukin-6, C-reactive protein, myeloperoxidase, Galectin-3, growth differentiation factor-15 are under investigation for their use in detecting cardiotoxicity early. In addition, microRNAs, genome-wide association studies and proteomics are being studied as novel markers of cardiovascular injury or inflammation. The aim of this literature review is to discuss the evidence base behind the use of these biomarkers for the detection of cardiotoxicity.

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Cardiac biomarkers indicate a need for sensitive cardiac imaging among long-term childhood cancer survivors exposed to anthracyclines

Cited by 15 publications

References 29 publications

Biomarkers to diagnose ventricular dysfunction in childhood cancer survivors: a systematic review

Biomarkers to diagnose ventricular dysfunction in childhood cancer survivors: a systematic review

3D echocardiography, arterial stiffness, and biomarkers in early diagnosis and prediction of CHOP-induced cardiotoxicity in non-Hodgkin’s lymphoma

The Role of Biomarkers in Cardio-Oncology

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