The Role of Biomarkers in Detection of Cardio-toxicity

Shah, Kevin; Yang, Eric H.; Maisel, Alan S.; Fonarow, Gregg C.

doi:10.1007/s11912-017-0602-9

Cited by 26 publications

(20 citation statements)

References 51 publications

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“…Troponin is considered to be the best suited cardiac biomarker for detecting CIC, cellular damage and apoptosis [15,16], but also for subclinical cardiac dysfunction [17]. TnI is more feasible than the other cardiac troponins for early CIC diagnosis due to its kinetic curve [18], but the exact dynamic of troponin release into bloodstream is not well known [5,12,19].…”

Section: Discussionmentioning

confidence: 99%

Cardiotoxicity evaluation in pediatric patients with acute lymphoblastic leukemia – results of prospective study

et al. 2019

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Aim: The chemotherapy protocol for acute lymphoblastic leukemia (ALL) uses low doses of anthracyclines (AC), generally associated with subclinical cardiotoxicity. The aim of our study was to evaluate the serum biomarkers and echocardiography parameters in children with ALL treated with AC in order to determine the most useful element for early detection of cardiotoxicity.Material and methods: In this prospective study, troponin I (TnI) and heart-type fatty acid binding protein (HFABP) were assessed five times during the first year after the onset of ALL. Serial Tissue Doppler Imaging and conventional cardiac echography were performed by two pediatric cardiologists (intraclass correlation coefficient over 0.85 for all measurements) in three periods during the study protocol.Results: We evaluated 48 children with ALL. TnI increased during therapy, without returning to baseline values one year after diagnosis. HFABP did not show significant changes during the study protocol. Left ventricle outflow tract time-velocity integral and peak systolic septal mitral annulus velocity decreased during chemotherapy and returned to baseline levels at one year after diagnosis, while peak systolic tricuspid annulus velocity and excursion, maintained a descending tendency. Early filling transmitral flow velocity and E/A ratio were also transiently influenced by chemotherapy.Conclusions: The study showed signs of transient cardiotoxicity in the left ventricle and diastolic parameters after chemotherapy, compared to right ventricle parameters which maintained low values even one year after diagnosis. TnI proved to be directly proportional to chemotherapy doses but HFABP was not useful in this setting

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Section: Discussionmentioning

confidence: 99%

Cardiotoxicity evaluation in pediatric patients with acute lymphoblastic leukemia – results of prospective study

et al. 2019

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“…Some clinical predictors have been reported for stratifying patients at risk, such as dosimetric parameters of RT (61), cardiac risk index (100), and coronary calcium score (101). Moreover, biomarkers are clinically helpful for detecting RACVD (102), such as cardiac troponins (e.g., troponin I or T) and natriuretic peptides (e.g., B-type natriuretic peptide (BNP) or pro-BNP) (103). On imaging, echocardiography is the pivotal method to detect cardiac anatomic and functional changes of RACVD (104-106).…”

Section: Challenges Of Clinical Detection For Racvdmentioning

confidence: 99%

Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care

Lee

Liu

Hung

et al. 2020

Front. Cardiovasc. Med.

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Radiotherapy (RT) is a crucial treatment modality in managing cancer patients. However, irradiation dose sprinkling to tumor-adjacent normal tissues is unavoidable, generating treatment toxicities, such as radiation-associated cardiovascular dysfunction (RACVD), particularly for those patients with combined therapies or pre-existing adverse features/comorbidities. Radiation oncologists implement several efforts to decrease heart dose for reducing the risk of RACVD. Even applying the deep-inspiration breath-hold (DIBH) technique, the risk of RACVD is though reduced but still substantial. Besides, available clinical methods are limited for early detecting and managing RACVD. The present study reviewed emerging challenges of RACVD in modern radiation oncology, in terms of clinical practice, bench investigation, and multidisciplinary care. Several molecules are potential for serving as biomarkers and therapeutic targets. Of these, miRNAs, endogenous small non-coding RNAs that function in regulating gene expression, are of particular interest because low-dose irradiation, i.e., 200 mGy (one-tenth of conventional RT daily dose) induces early changes of pro-RACVD miRNA expression. Moreover, several miRNAs, e.g., miR-15b and miR21, involve in the development of RACVD, further demonstrating the potential bio-application in RACVD. Remarkably, many RACVDs are late RT sequelae, characterizing highly irreversible and progressively worse. Thus, multidisciplinary care from oncologists and cardiologists is crucial. Combined managements with commodities control (such as hypertension, hypercholesterolemia, and diabetes), smoking cessation, and close monitoring are recommended. Some agents show abilities for preventing and managing RACVD, such as statins and angiotensin-converting enzyme inhibitors (ACEIs); however, their real roles should be confirmed by further prospective trials.

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“…Cardiac imaging and biomarkers have been found to be useful in baseline assessment as well as the early detection of cardiotoxicity once treatment begins (Altena et al, 2009;Zamorano et al, 2016). N-terminal pro-brain natriuretic peptide (NT-proBNP), troponin I, and brain-type natriuretic peptide (BNP) levels have been shown to predict a drop in LV function during cardiotoxic chemotherapy and can be followed in a serial fashion for continued surveillance (Cardinale et al, 2017;Lenihan et al, 2016;Shah, Yang, Maisel, & Fonarow, 2017).…”

Section: Early Detection Of Cardiac Dysfunctionmentioning

confidence: 99%

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

Coviello¹

2018

JADPRO

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Cardio-oncology is a subspecialty of cardiology. It was created to address oncology data indicating that newly developed drugs for cancer treatment were having unanticipated cardiac side effects. Cardiooncology designs primary and secondary risk strategies through surveillance as well as interventions to reduce cardiovascular risk (CVR), prevent cardiotoxicities, and manage the side effects that may occur. Rather than discuss in detail the cardiotoxicities of specific therapies or radiation, this review article will explore the interplay of cancer, cancer treatment, and CVR. It will examine the link between CVR and cancer risk, define mechanisms associated with cardiotoxicity, and describe screening and surveillance for patients undergoing cancer treatment. Finally, effective preventative and management strategies used to reduce the incidence of cardiotoxicities in those receiving chemotherapeutics or radiation will be presented.

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The Role of Biomarkers in Detection of Cardio-toxicity

Cited by 26 publications

References 51 publications

Cardiotoxicity evaluation in pediatric patients with acute lymphoblastic leukemia – results of prospective study

Cardiotoxicity evaluation in pediatric patients with acute lymphoblastic leukemia – results of prospective study

Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

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