Chemotherapy-induced cardiotoxicity: importance of early detection

Cardinale, Daniela; Cipolla, Carlo M.

doi:10.1080/14779072.2016.1239528

Cited by 17 publications

(11 citation statements)

References 23 publications

(27 reference statements)

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“…There is evidence to substantiate the use of troponins as a marker of cardiovascular toxicities, such that elevated troponins during anthracyclines are associated with more adverse outcomes and are a significant marker of cardiac dysfunction [46,74,149,153,154]. Nevertheless, other studies including ICOS-1 [149] have demonstrated that troponin may not always be the most suitable biomarker by demonstrating that it is possible for it to rise independently of cardiotoxicity.…”

Section: Resultsmentioning

confidence: 99%

The Role of Biomarkers in Cardio-Oncology

Ananthan

Lyon

2020

J. of Cardiovasc. Trans. Res.

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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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Section: Resultsmentioning

confidence: 99%

The Role of Biomarkers in Cardio-Oncology

Ananthan

Lyon

2020

J. of Cardiovasc. Trans. Res.

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“…To be practical, anthracycline-associated cardiotoxicity is now thought to occur at the time of first exposure, a hypothesis supported by the finding of troponin release after anthracycline administration (16). Clinical presentation may occur years later the initial damage (16)(17)(18). Looking at symptoms, the diagnosis may take years ("late" cardiotoxicity).…”

Section: Classificationmentioning

confidence: 99%

“…With the use of circulating biomarkers, such as troponin (pre-clinical myocardial cell damage), prompt identification of cardiotoxicity is possible, allowing for an "acute" form. So far, we are probably observing the evolving stages of the same phenomenon and not three distinct diseases (15,17,18).…”

Section: Classificationmentioning

confidence: 99%

“…The diagnosis of anthracycline-induced cardiotoxicity has remained the same over the last 60 years. It has always been based on heart failure symptoms, and, later, also on evidence of LVEF drop (echocardiography or multi-gated acquisition scans) (4,18). A former definition adopted was an LVEF absolute decrease higher than 10% points, associated with a decline <50% (5).…”

Section: Diagnosis and Definitionmentioning

confidence: 99%

“…Otherwise, the international cardiological guidelines recommend monitoring of cardiac function by serial LVEF measurements, but do not provide an accurate indication on timing, frequency, modalities, and long-term schedule (7). Moreover, a diagnosis based on symptoms or asymptomatic decrease of LVEF is not only delayed, but also potentially prevents any form of effective prevention, as the cardiac damage may be no longer reversible (17,18).…”

Section: Diagnosis and Definitionmentioning

confidence: 99%

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Cardiotoxicity of Anthracyclines

Cardinale

Fabiani

Cipolla

2020

Front. Cardiovasc. Med.

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229

161

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Cardiotoxicity is a feared side effect that may limit the clinical use of anthracyclines. It may indeed affect the quality of life and survival of patients with cancer, regardless of oncological prognosis. This paper provides an overview of anthracycline-induced cardiotoxicity in terms of definition, classification, incidence, risk factors, possible mechanisms, diagnosis, and treatment. We also report effective strategies for preventing cardiotoxicity. In addition, we discuss limiting current approaches, the need for a new classification, and early cardiotoxicity detection and treatment. Probably, anthracycline-induced cardiotoxicity is a continuous phenomenon that starts from myocardial cell injury; it is followed by left ventricular ejection fraction (LVEF) and, if not diagnosed and cured early, progressively leads to symptomatic heart failure. Anthracycline-induced cardiotoxicity can be detected at a preclinical phase. The role of biomarkers, in particular troponins, in identifying subclinical cardiotoxicity and its therapy with angiotensin-converting enzyme inhibitors (mainly enalapril) to prevent LVEF reduction is a recognized and effective strategy. If cardiac dysfunction has already occurred, partial or complete LVEF recovery may still be obtained in case of early detection of cardiotoxicity and prompt heart failure treatment.

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