Troponins and natriuretic peptides in the monitoring of anthracycline cardiotoxicity

Pediatric Cardiology Unit, Department of Pediatrics, University Hospital of Heraklion, Crete, Greece.
Pediatric Blood & Cancer (Impact Factor: 2.39). 09/2008; 51(3):327-33. DOI: 10.1002/pbc.21633
Source: PubMed


Anthracycline-related cardiotoxicity has a substantial negative impact on long-term survivors of childhood cancer. The detection of cardiotoxicity is currently based on echocardiography or radionuclide angiography. However, as they depict only the final outcome of myocardial injury in terms of reduced heart contractility, heart specific biomarkers of myocardial destruction or dysfunction could be advantageous by allowing for an earlier detection of cardiotoxicity. In the present study, the usefulness of cardiac troponins and natriuretic peptides, the most commonly used biomarkers of myocardial destruction and ventricular dysfunction respectively, to detect and to predict the development of anthracycline cardiotoxicity has been reviewed.

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    • "The best studied blood biomarkers of myocardial injury and remodeling include cardiac troponins (cTn) and natriuretic peptides (NP). While cTn's have successfully been used to monitor acute anthracycline-related cardiotoxicity, [24] little is known regarding their utility for diagnosis and monitoring of long-term chronic cardiac injury [48]. cTn levels have failed to identify mild heart dysfunction in patients followed long-term, [49, 50] arguing against their use as a biomarker of response to pharmacologic intervention. "
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    • "3. Other techniques have also been tested: Antimyosin antibody scintigraphy is a marker of cardiac damage, but its high sensitivity may produce positive results at very low cumulative doses of anthraciclines, thus limiting its clinical utility (Valdes Olmos et al., 2002). Cardiac troponins and natriuretic peptides, the most commonly used biomarkers of myocardial destruction and ventricular dysfunction respectively, have also been studied for this purpose (Germanakis et al., 2008). Pretherapy baseline evaluation of LVEF is recommended for all patients with AL before starting induction therapy. "

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