Early anthracycline‐induced cardiotoxicity monitored by echocardiographic Doppler parameters combined with serum hs‐<scp>cTnT</scp>

Zhang, Chujie; Pei, Xiaoli; Song, Feiyan; Guo, Ye; Zhang, Qunling; Shu, Xianhong; Hsi, David H.; Cheng, Leilei

doi:10.1111/echo.13704

Cited by 17 publications

(20 citation statements)

References 28 publications

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“…Finally, in the lack of consistent data, we strongly recommend clinicians to consider an integrated biomarker approach, combining circulating biomarkers with imaging methods. This combined technique showed indeed improved specificity, while sensitivity, as expected, dropped [9,33,34].…”

Section: Other Circulating Biomarkers In Cardio-oncologysupporting

confidence: 77%

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Cardiac Biomarkers in Patients with Cancer: Considerations, Clinical Implications, and Future Avenues

et al. 2020

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Purpose of the Review As the number of cancer survivors increases due to early screening and modern (antineoplastic) treatments, cancer treatment associated cardiotoxicity (CTAC) is becoming an increasing health burden that affects survival and quality of life among cancer survivors. Thus, clinicians need to identify adverse events early, in an effort to take suitable measures before the occurrence of permanent or irreversible cardiac dysfunction. Recent Findings Cardiac troponin (cTn) and B-type natriuretic peptide (BNP) have been proven to detect subclinical cardiotoxicity during antineoplastic treatment. As such, these cardio-specific biomarkers could predict which patients are at risk of developing CTAC even before the start of therapy. Nevertheless, there are inconsistent data from published studies, and the recommendations regarding the use of these biomarkers and their validity are mostly based on expert consensus opinion. Summary In this review, we summarize available literature that evaluates biomarkers of CTAC, and we encourage strategies that integrate circulating biomarkers and cardiac imaging in identifying cancer patients that are at high risk.

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Section: Other Circulating Biomarkers In Cardio-oncologysupporting

confidence: 77%

“…The predictive value of hs-cTn is consistent among other neoplasm patients as well. Zhang et al followed patients with B cell lymphoma receiving anthracyclines [33]. They have also reported a significant hs-cTn rise following anthracycline treatment.…”

Section: Cardiac Troponins Predictors Of Ctacmentioning

confidence: 99%

Cardiac Biomarkers in Patients with Cancer: Considerations, Clinical Implications, and Future Avenues

et al. 2020

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“…A number of foreign research results show that LVEF values were not significantly reduced when the average cumulative dose of anthracycline was up to 350-700 mg/m 2. [16][17][18] In our study, LVEF was significantly reduced when the cumulative dose of anthracycline was at 320 mg/m 2 . Previous studies on the sensitivity of GLS in monitoring anthracycline-induced myocardial damage showed that when the average cumulative dose was 60 mg/m 2 , GLS did not decrease significantly, 19 and when the average cumulative dose was 266 mg/m 2 (200-298 mg/m 2 ), GLS decreased significantly.…”

Section: Discussionsupporting

confidence: 47%

Use of echocardiography to monitor myocardial damage during anthracycline chemotherapy

Anqi

Zhang

et al. 2019

Echocardiography

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Background Anthracycline‐related cardiotoxicity has a poor prognosis; therefore, early detection of any change in LV function is critical. Objective The aim of this study was to evaluate the two‐dimensional speckle tracking technique for the early detection of cardiac toxicity after low‐dose anthracycline chemotherapy in the Chinese population. Methods Forty breast cancer patients were treated by chemotherapy using anthracycline for 4–6 cycles. Patients were examined by echocardiography before chemotherapy (T0) and after the second (T2), fourth (T4), and sixth (T6) cycle. LV ejection fraction (LVEF), LV global longitudinal strain (GLS) and endocardium, mid‐myocardium, and epicardium global longitudinal strain (GLS‐Endo, GLS‐Mid, and GLS‐Epi). Additionally, global circumferential strain (GCS), RV global longitudinal strain (RVGLS), and LA global longitudinal strain (LAGLS) were evaluated. Results Left ventricular ejection fraction was significantly reduced at T4 (P < 0.05). Compared with T0, GLS, GLS‐Endo, GLS‐Mid, and GLS‐Epi were significantly reduced at T2, T4, and T6 (P < 0.05 for all), the apical septum wall (AS) was also reduced significantly at T2 (P < 0.05), and the apical anterior wall (AA) and the basal anterior wall (BA) longitudinal strains were significantly reduced at T4 (P < 0.05). GCS, RVGLS, and LAGLS were not significantly changed after treatment (P > 0.05). Conclusions LV stratified strains and strain of the segments supplied by the left anterior descending coronary artery are more sensitive to the cardiac toxicity of anthracycline.

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“…Some biomarkers [34][35][36] and decreased global longitudinal strain [37,38] have been reported to be useful in the early diagnosis of cardiotoxicity. Furthermore, early diagnosis and therapy for cardiotoxicity have been reported to be associated with better outcome [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Clinical features of anthracycline‐induced cardiotoxicity in patients with malignant lymphoma who received a CHOP regimen with or without rituximab: A single‐center, retrospective observational study

Nakayama

Oshima

Kusumoto

et al. 2020

eJHaem

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We investigated the incidence of cardiotoxicity, its risk factors, and the clinical course of cardiac function in patients with malignant lymphoma (ML) who received a cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) regimen. Among all ML patients who received a CHOP regimen with or without rituximab from January 2008 to December 2017 in Nagoya City University hospital, 229 patients who underwent both baseline and follow‐up echocardiography and had baseline left ventricular ejection fraction (LVEF) ≥50% were analyzed, retrospectively. Cardiotoxicity was defined as a ≥10% decline in LVEF and LVEF < 50%; recovery from cardiotoxicity was defined as a ≥5% increase in LVEF and LVEF ≥50%. Re‐cardiotoxicity was defined as meeting the criteria of cardiotoxicity again. With a median follow‐up of 1132 days, cardiotoxicity, symptomatic heart failure, and cardiovascular death were observed in 48 (21%), 30 (13%), and 5 (2%) patients, respectively. Multivariate analysis demonstrated that history of ischemic heart disease (hazard ratio (HR), 3.15; 95% CI, 1.17‐8.47, P = .023) and decreased baseline LVEF (HR per 10% increase, 2.55; 95% CI, 1.49‐4.06; P < .001) were independent risk factors for cardiotoxicity. Recovery from cardiotoxicity and re‐cardiotoxicity were observed in 21 of 48, and six of 21, respectively. Cardiac condition before chemotherapy seemed to be most relevant for developing cardiotoxicity. Furthermore, Continuous management must be required in patients with cardiotoxicity, even after LVEF recovery.

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Early anthracycline‐induced cardiotoxicity monitored by echocardiographic Doppler parameters combined with serum hs‐cTnT

Abstract: We demonstrated that echocardiographic PW Doppler-derived Tei index, and TDI-derived Sm, combined with serum hs-cTnT level can be obtained in outpatient settings to monitor early cardiac toxicity induced by anthracycline therapy.

Cited by 17 publications

References 28 publications

Cardiac Biomarkers in Patients with Cancer: Considerations, Clinical Implications, and Future Avenues

Cardiac Biomarkers in Patients with Cancer: Considerations, Clinical Implications, and Future Avenues

Use of echocardiography to monitor myocardial damage during anthracycline chemotherapy

Clinical features of anthracycline‐induced cardiotoxicity in patients with malignant lymphoma who received a CHOP regimen with or without rituximab: A single‐center, retrospective observational study

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