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
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.
Available from: ncbi.nlm.nih.gov
- "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,  little is known regarding their utility for diagnosis and monitoring of long-term chronic cardiac injury . 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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ABSTRACT: Cardiovascular complications are a leading cause of therapy-related morbidity and mortality in long-term survivors of childhood malignancy. In fact, childhood cancer survivors are at a 15-fold risk of developing CHF compared to age-matched controls. There is a strong dose-dependent association between anthracycline exposure and risk of CHF, and the incidence increases with longer followup. Outcome following diagnosis of CHF is generally poor, with overall survival less than 50% at 5 years. The growing number of childhood cancer survivors makes it imperative that strategies be developed to prevent symptomatic heart disease in this vulnerable population. We present here an overview of the current state of knowledge regarding primary, secondary, and tertiary prevention strategies for childhood cancer survivors at high risk for CHF, drawing on lessons learned from prevention studies in nononcology populations as well as from the more limited experience in cancer survivors.
Available from: Guillermo Gervasini
- "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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ABSTRACT: In this paper, a Cold Cathode Fluorescent(CCFL) model for high frequency dimming electric ballast simulation is presented. The model can be utilized for an electronic ballast simulation with continues dimming and transient mode simulation such as step dimming. The model is implemented using a MATLAB and PSPICE The piezoelectric transformer is evaluated using an AC equivalent analysis. We are proposes an electronic ballast utilizing piezoelectric transformer for fluorescent lamps. The electronic ballast composed of piezoelectric transformers and Zero Voltage Switching(ZVS) inverter was implemented. It enables a fluorescent lamp to be turned on stably. Accordingly, simulation of a high frequency electronic ballast which operates a fluorescent lamp at high frequency is proposed. Simulation is carried out using MATLAB and PSPICE program to illustrate the performance to the circuit.
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