Early Detection and Prediction of Cardiotoxicity - Biomarker and Echocardiographic Evaluation

Goudev, Assen

doi:10.5772/33561

Cited by 3 publications

(6 citation statements)

References 89 publications

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“…The incidence of cardiotoxicity after AC treatment is influenced by multiple factors, among the most important ones being the type of chemotherapy, the total given dose, and age at onset of therapy [ 26 ].…”

Section: Chemotherapy-induced Cardiotoxicitymentioning

confidence: 99%

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Cardiotoxicity: A Major Setback in Childhood Leukemia Treatment

et al. 2021

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Ongoing research in the field of pediatric oncology has led to an increased number of childhood cancer survivors reaching adulthood. Therefore, ensuring a good quality of life for these patients has become a rising priority. Considering this, the following review focuses on summarizing the most recent research in anthracycline-induced cardiac toxicity in children treated for leukemia. For pediatric cancers, anthracyclines are one of the most used anticancer drugs, with over half of the childhood cancer survivors believed to have been exposed to them. Anthracyclines cause irreversible cardiomyocyte loss, leading to chronic, progressive heart failure. The risk of developing cardiotoxicity has been known to increase with the treatment-free interval and total cumulative dose. However, because of individual variations in anthracycline metabolism, it has recently been shown that there is no risk-free dose. Moreover, studies have shown that diagnosing anthracycline-induced cardiomyopathy in the symptomatic phase is associated with poor treatment response and prognosis. Thus, early and systematic evaluation of these patients is crucial to allow optimal therapeutic intervention. Although currently echocardiographic assessment of left ventricle ejection fraction and cardiac biomarker evaluation are being used for cardiac function monitoring in oncologic patients, there is no established follow-up and treatment protocol for these patients, and these methods are neither specific nor sensitive for identifying early cardiac dysfunction. All things considered, the need for ongoing research in the field of pediatric cardiooncology is crucial to offer these patients a chance at a good quality of life as adults.

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Section: Chemotherapy-induced Cardiotoxicitymentioning

confidence: 99%

“…In the first year following treatment, ultrasound screening is currently recommended at 3, 6, and 12 months [ 26 ]. COG provides a detailed guide on the frequency of posttreatment monitoring, based on age at exposure to AC, the total dose received, and the association with thoracic irradiation.…”

Section: Monitoring Patients With Anthracyclinementioning

confidence: 99%

Cardiotoxicity: A Major Setback in Childhood Leukemia Treatment

et al. 2021

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“…The cumulative doxorubicin dose is the most important risk factor associated with chronic cardiotoxicity. 18 The minimum total cumulative dose of doxorubicin that can lead to cardiotoxicity is 250 mg/m 2 . 19…”

Section: Introductionmentioning

confidence: 99%

“…21 Therefore, keeping the total cumulative doxorubicin dose below a threshold of 450 mg/m 2 is currently the only method that may help to reduce cardiotoxicity. 18 Numerous studies were conducted with antioxidants like vitamin C, vitamin E, selenium, carotenoids, β-carotene, N -acetylcysteine, coenzyme Q10, glutathione peroxidase and levocarnitine to determine if these can be used as prophylactic agents against anthracycline-induced cardiotoxicity. The results have however been inconclusive.…”

Section: Introductionmentioning

confidence: 99%

A prospective study to evaluate the efficacy and safety of vitamin E and levocarnitine prophylaxis against doxorubicin-induced cardiotoxicity in adult breast cancer patients

Moustafa

Connolly

Anis

et al. 2023

J Oncol Pharm Pract

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Background Doxorubicin induces acute and chronic cardiotoxicity. This study is aimed to evaluate the efficacy and safety of vitamin E and levocarnitine (EL) as cardioprotective agents against acute doxorubicin cardiotoxicity in female adult breast cancer patients. Methods A prospective, randomized controlled study was conducted in patients treated with doxorubicin and cyclophosphamide (AC). Patients were randomly assigned to EL plus AC or AC alone for the duration of 4 cycles. Cardiac enzymes (B-type natriuretic peptide, creatine kinase, troponin I (Trop)) and cardiac events were monitored during treatment to evaluate the cardioprotective efficacy of EL. Results Seventy-four patients were recruited and received four cycles of chemotherapy. The intervention group ( n = 35) showed a significant reduction in both the B-type natriuretic peptide and creatine kinase cardiac enzymes compared to the control group ( n = 39). The median (IQR) change for BNP was 0.80 (0.00–4.00) for IG versus 1.80 (0.40–3.60) for CG groups ( p < 0.001); creatine kinase was −0.08 (−0.25–0.05) for IG versus 0.20 (0.05–0.50) for CG ( p < 0.001). The addition of EL decreased the cardiac events by 24.2% ( p = 0.02). All adverse events were tolerable and manageable. Conclusion This study supports the addition of EL as prophylaxis against acute doxorubicin cardiotoxicity and it was also very well tolerated by a majority of the patients. The co-administration of EL at higher doxorubicin (240 mg/m2) dose should be further investigated.

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“…The adopted diagnostic approach depended mainly on the estimation of left ventricle ejection fraction (LVEF) or left ventricle fractional shortening (LVFS) using conventional echocardiography. Although this approach showed low sensitivity toward early prediction [5,9], it is still used for monitoring left ventricular function in both clinical practice and clinical trials [12].…”

Section: Introductionmentioning

confidence: 99%

Doxorubicin Cardiotoxicity in Acute Lymphoblastic Leukemia: Possible Protective Role of Grape Seed Extract Proanthocyanidins

El-Dakroory

2014

BJMMR

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Aim: To evaluate early doxorubicin (DOX) cardiotoxicity in asymptomatic leukemic patients and to explore whether Grape seed extract (GSE) proanthocyanidins would prevent the DOX-induced cardiotoxicity. Study Design: Prospective randomized double blind study. Place and Duration of Study: This study was conducted in Mansoura University Hospital, between January 2011 and May 2013. Forty two newly diagnosed acute lymphoblastic leukemia (ALL) patients were enrolled, their ages ranged from 9 to14 years. They were divided into two groups; group I received Doxorubicin-containing chemotherapy while Group II was treated with Doxorubicin-containing chemotherapy plus GSE all over the study period. All patients underwent clinical, echocardiographic and laboratory evaluations at the end of induction (phase I) and at the end of CNS intensification (phase II). Serum malondialdehyde (MDA) level, high sensitive cardiac

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Early Detection and Prediction of Cardiotoxicity - Biomarker and Echocardiographic Evaluation

Cited by 3 publications

References 89 publications

Cardiotoxicity: A Major Setback in Childhood Leukemia Treatment

Cardiotoxicity: A Major Setback in Childhood Leukemia Treatment

A prospective study to evaluate the efficacy and safety of vitamin E and levocarnitine prophylaxis against doxorubicin-induced cardiotoxicity in adult breast cancer patients

Doxorubicin Cardiotoxicity in Acute Lymphoblastic Leukemia: Possible Protective Role of Grape Seed Extract Proanthocyanidins

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