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Hematology. 2012 May;17(3):151-6. doi: 10.1179/102453312X13376952196412.

Biomarkers and early detection of late onset anthracycline-induced cardiotoxicity in children.

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1
Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt.

Abstract

BACKGROUND:

The main strategy for minimizing anthracycline cardiotoxicity is early detection of high-risk patients.

AIM OF THE STUDY:

To investigate the role of cardiac biomarkers; cardiac troponin T (cTnT) and N-terminal probrain natriuretic peptide (NT-pro-BNP), and tissue Doppler imaging (TDI), as early predictors of chronic cardiotoxicity in survivors of acute leukemia.

PATIENTS AND METHODS:

We carried a retrospective study on 50 asymptomatic survivors of acute leukemia who received anthracycline in their treatment protocols. All patients underwent blood sampling to determine the levels of NT-pro-BNP and cTnT along with conventional echocardiography and TDI.

RESULTS:

None had abnormal cTnT levels. About 20% had abnormal NT-pro-BNP levels. Diastolic dysfunction of the left ventricle was the most significant in conventional echocardiography. TDI was superior as it detected myocardial affection in 10% more than echo. TDI demonstrated global myocardial damage with significant aberrations in peak myocardial velocities and ratios.

CONCLUSIONS:

NT-pro-BNP can be used as a sensitive cardiac biomarker in monitoring of anthracycline-induced cardiotoxicity. Follow up is essential to validate the role of NT-pro-BNP as an early marker for late onset anthracycline-induced cardiotoxicity. Tissue Doppler is marvelous as it could detect early cardiac dysfunction even in those with normal study by conventional echocardiography.

[Indexed for MEDLINE]

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