MEDiastinal Irradiation and CArdio-Toxic Effects (MEDICATE): Exploring the Relationship between Cardiac Irradiation and High Sensitivity Troponins

Donovan, Elysia; Dhesy‐Thind, Sukhbinder; Swaminath, Anand; Leong, Darryl P.; Pond, Greg; Voruganti, S.; Sussman, Jonathan; Wright, Jim; Okawara, Gordon; Kavsak, Peter A.; Dokainish, Hisham; Fraser, Graham M.; Sagar, Stephen M.

doi:10.1016/j.clon.2019.04.003

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…Some other studies did not show significant changes in biomarkers levels after radiotherapy. Donovan et al measured highly sensitive TnI and TnT before and during radiotherapy at week two and four; they found no significant increase in the two markers, but the study population was very small and the cumulative radiation dose was low [63]. De Sanctis et al found no increase in cardiac TnI and BNP levels from baseline related to left breast irradiation [64].…”

Section: Radiotherapymentioning

confidence: 99%

Role of Cardiac Biomarkers in Cancer Patients

Semeraro

Cipolla

Cardinale

2021

Cancers

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In patients with cancer—and especially some specific subtypes—the heart can be pathologically affected due to the direct action of the tumor or its secretion products or due to the toxicity of some oncological treatments. Cardiac biomarkers have been investigated as inexpensive and easily accessible tools for prediction, early diagnosis, monitoring, or prognosis of various forms of cancer-related cardiac diseases. However, their clinical usefulness was not always clearly demonstrated in every area of cardioncology. For the identification of anthracycline related cardiotoxicity in the very early stages troponins proved to be more efficient detectors than imaging methods. Nevertheless, the lack of a standardized dosage methodology and of cardiotoxicity specific thresholds, do not yet allow to outline the precise way to employ them in clinical routine and to incorporate them into appropriate diagnostic or managing algorithms. Cardiac biomarkers proved also effective in patients with primary cardiac amyloidosis, in which both troponins and natriuretic peptides were able to predict adverse outcome, and carcinoid heart disease, where a precise diagnostic cut-off for N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was identified to screen patients with valvular involvement. Likewise, NT-proBNP proved to be an excellent predictor of postoperative atrial fibrillation (POAF). On the contrary, evidence is still not sufficient to promote the routine use of cardiac biomarkers to early diagnose myocarditis due to immune check points inhibitors (ICIs), radiotherapy induced cardiotoxicity and cardiac complications related to androgenetic deprivation. In this review we present all the evidence gathered so far regarding the usefulness and limitations of these relatively inexpensive diagnostic tools in the field of cardio-oncology.

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Section: Radiotherapymentioning

confidence: 99%

Role of Cardiac Biomarkers in Cancer Patients

Semeraro

Cipolla

Cardinale

2021

Cancers

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“…Echocardiographic imaging has demonstrated detection in early changes in left ventricular ejection fraction (LVEF) and global longitudinal left ventricular strain, which may be a promising method of identifying subclinical early regional myocardial dysfunction. LVEF decrease and strain increase were found to be related to cardiac doses (27). While it has not been delineated which cardiac chambers are affected most by radiation, some studies have found a significant association with the dose to the left ventricle (28).…”

Section: Lvef and Strainmentioning

confidence: 99%

Radiation and cardiovascular disease

Palaskas¹,

Patel²,

Yusuf³

2019

Ann Transl Med

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“…Mixed evidence exists as to the utility of cTnT and BNP in detecting RICD. In patients with lymphoma or thoracic cancers receiving ≥ 30 Gy to 5% of cardiac volume or mean heart dose (MHD) of ≥ 4 Gy ( n = 19, ~ 90% received chemotherapy), Donovan et al found no association of high-sensitivity (hs) TnI and hsTnT with cardiac dose, and in breast cancer patients treated with hypofractionated radiation ( n = 44, ~ 57% received chemotherapy) [ 47 ], De Sanctis et al reported no significant increases in either cTnI or NT-proBNP [ 48 ]. Although Gomez et al found that 2/25 patients receiving 45 Gy to the whole thorax or 20 Gy to the heart had elevated cTnI and BNP at the end of radiation treatment, these changes did not reach statistical significance [ 49 ].…”

Section: Advances In Biomarkersmentioning

confidence: 99%

Advances in Screening for Radiation-Associated Cardiotoxicity in Cancer Patients

Schiffer,

Pedersen,

Lui

et al. 2023

Curr Cardiol Rep

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Purpose of Review Radiation is foundational to the treatment of cancer and improves overall survival. Yet, it is important to recognize the potential cardiovascular effects of radiation therapy and how to best minimize or manage them. Screening—both through imaging and with biomarkers—can potentially identify cardiovascular effects early, allowing for prompt initiation of treatment to mitigate late effects. Recent Findings Cardiac echocardiography, magnetic resonance imaging (MRI), computed tomography, and measurements of troponin and natriuretic peptides serve as the initial screening tests of choice for RICD. Novel imaging applications, including positron emission tomography and specific MRI parameters, and biomarker testing, including myeloperoxidase, growth differentiation factor 15, galectin 3, micro-RNA, and metabolomics, hold promise for earlier detection and more specific characterization of RICD. Summary Advances in imaging and novel applications of biomarkers have potential to identify subclinical RICD and may reveal opportunities for early intervention. Further research is needed to elucidate optimal imaging screening modalities, biomarkers, and surveillance strategies.

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MEDiastinal Irradiation and CArdio-Toxic Effects (MEDICATE): Exploring the Relationship between Cardiac Irradiation and High Sensitivity Troponins

Cited by 6 publications

References 22 publications

Role of Cardiac Biomarkers in Cancer Patients

Role of Cardiac Biomarkers in Cancer Patients

Radiation and cardiovascular disease

Advances in Screening for Radiation-Associated Cardiotoxicity in Cancer Patients

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