Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: A systematic review

Bryant, Jackie; Picot, Joanna; Baxter, Laurence A.; Levitt, G.; Sullivan, Ian D.; Clegg, Andrew

doi:10.1016/j.ejca.2007.06.012

Cited by 44 publications

(40 citation statements)

References 16 publications

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“…Thus, there is a growing expectation for newer, noninvasive and cost-effective diagnostic tools for the early identification of patients susceptible to developing CTinduced cardiotoxicity 22 . The use of easily detectable cardiac biomarkers in blood has been evaluated in animal models and clinical studies [23][24][25][26][27] . Screening of high-risk patients is recommended for the detection of early subclinical cardiotoxicity.…”

Section: Diagnostic Methods For Identification Of Ct-induced Cardiotomentioning

confidence: 99%

Biomarkers for the early detection of anthracycline-induced cardiotoxicity: current status

Horáček¹,

Vašatová²,

Pudil³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Cardiotoxicity is a well-known and potentially serious complication of anticancer therapy. Anthracyclinebased chemotherapy represents the greatest risk. Early detection of cardiotoxicity is crucial for applying preventive and supportive therapeutic strategies. Methods and Results. Various methods have been recommended for monitoring of cardiotoxicity. In our conditions, echocardiography and electrocardiography are routinely used. However, this approach shows low sensitivity for the early prediction of cardiomyopathy when the possibilities of appropriate management could still improve the patient's outcome. Recently, biomarkers of cardiac injury have been investigated in the assessment of chemotherapy-induced cardiotoxicity. Cardiospecific biomarkers, such as cardiac troponins, show high diagnostic efficacy in the early subclinical phase of the disease before the clinical onset of cardiomyopathy. Increase in their concentrations correlates with disease severity. As for natriuretic peptides, some studies, including ours, have shown promising results. Definitive evidence of their diagnostic and prognostic role in this context is still lacking and natriuretic peptides have not been routinely used for monitoring of cardiotoxicity in clinical practice. Other perspective biomarkers of cardiotoxicity in oncology are under study, especially heart-type fatty acid-binding protein (H-FABP) and glycogen phosphorylase BB (GPBB). Our studies using GPBB have provided encouraging results. However, the available data are limited and their practical use in this context cannot be recommended until their clinical efficacy is clearly defined. Conclusions. This review covers the current status of biomarkers for the early detection of anthracycline-induced cardiotoxicity. The authors present in brief, their own experience with multiple biomarkers in the detection of cardiotoxicity.

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Section: Diagnostic Methods For Identification Of Ct-induced Cardiotomentioning

confidence: 99%

Biomarkers for the early detection of anthracycline-induced cardiotoxicity: current status

Horáček¹,

Vašatová²,

Pudil³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Plasma levels are used as a prognostic indicator in different stages and causes of cardiac disease (Doust et al, 2005). However, its role in detecting chemotherapy-induced cardiac morbidity has not been established yet (Bryant et al, 2007;Ekstein et al, 2007).…”

mentioning

confidence: 99%

Evaluation of sub-acute changes in cardiac function after cisplatin-based combination chemotherapy for testicular cancer

et al. 2009

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Long-term cardiovascular morbidity is increasingly observed in chemotherapy-treated testicular cancer survivors, but little is known of early sub-clinical changes in cardiac function. We prospectively evaluated cardiac function in testicular cancer patients by echocardiography. Systolic (Wall Motion Score Index) and diastolic (E/A-ratio and Tissue Velocity Imaging (TVI)) parameters, and serum levels of N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) were assessed before the start of chemotherapy and 1 year later. Echocardiography data were compared with an age-matched group of healthy controls. Forty-two patients treated with bleomycin, etoposide and cisplatin were evaluated (median age 27 years, range 18 -50). Systolic function and E/A-ratio did not change, whereas the median TVI decreased (12.0 vs 10.0 cm s À1 ; P ¼ 0.002). Median levels of NT-proBNP increased (5 vs 18 pmol l À1 , P ¼ 0.034). Compared with controls, TVI before the start of chemotherapy was not significantly different. In conclusion, we found that at a median of 10 months after cisplatin-based treatment for testicular cancer, TVI decreased significantly, indicating a deterioration of diastolic cardiac function. Serum levels of NT-proBNP increased. The prognostic significance of these changes for future cardiovascular morbidity is not clear.

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“…On the other hand, some studies using natriuretic peptides in the detection of CT-induced cardiotoxicity reported limited clinical usefulness of this method [19,59,60].…”

Section: • 23 Natriuretic Peptides As Markers Of Ct-induced Cardiotmentioning

confidence: 99%

“…The use of easily detectable cardiac biomarkers in blood has been evaluated in animal models and clinical studies [16][17][18][19][20][21]. Screening of high-risk patients is recommended for the detection of early subclinical cardiotoxicity.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of Cardiac Injury in Detection of Cardiotoxicity Induced by Chemotherapeutic Agents

Horáček¹

2011

Mil. Med. Sci. Lett.

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SummaryCardiotoxicity is a well-known and potentially serious complication of oncology treatment. Anthracyclines and high-dose chemotherapy especially regimens containing high-dose Cyclophosphamide represent the greatest risk. Early detection of cardiotoxicity is crucial for applying preventive and supportive therapeutic strategies. Various methods have been recommended for monitoring of cardiotoxicity. In our conditions, echocardiography and electrocardiography are routinely used. However, this approach shows low sensitivity for the early prediction of cardiomyopathy when the possibilities of appropriate management could still improve the patient's outcome.Recently, biomarkers of cardiac injury have been investigated in the assessment of chemotherapy-induced cardiotoxicity. Cardiospecific biomarkers, such as cardiac troponins, show high diagnostic efficacy in the early subclinical phase of the disease before the clinical onset of cardiomyopathy. The increase in their concentrations correlates with disease severity. As for natriuretic peptides, some studies, including ours, have shown promising results. Definitive evidence of their diagnostic and prognostic role in this context is still lacking and natriuretic peptides have not been routinely used for monitoring of cardiotoxicity in clinical practice. Other perspective biomarkers of cardiotoxicity in oncology are under study, especially heart-type fatty acid-binding protein (H-FABP) and glycogen phosphorylase BB (GPBB). Our studies using GPBB have brought priority and encouraging results. However, the available data are limited and their practical use in this context cannot be recommended until their clinical efficacy is clearly defined.The author presents his own experience with multiple biomarkers of cardiac injury in the detection of cardiotoxicity associated with conventional and high-dose chemotherapy for hematological malignancies.

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Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: A systematic review

Cited by 44 publications

References 16 publications

Biomarkers for the early detection of anthracycline-induced cardiotoxicity: current status

Biomarkers for the early detection of anthracycline-induced cardiotoxicity: current status

Evaluation of sub-acute changes in cardiac function after cisplatin-based combination chemotherapy for testicular cancer

Biomarkers of Cardiac Injury in Detection of Cardiotoxicity Induced by Chemotherapeutic Agents

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