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Biomarkers and early detection of late onset anthracycline-induced cardiotoxicity in children
Faculty
Medicine
Year:
2012
Type of Publication:
Article
Pages:
151-156
Authors:
Sherief, Laila M, Kamal, Ahmad G, Khalek, E. A, Kamal, Naglaa M, Soliman, Attia A. A, Esh, Asmaa M
DOI:
10.1179/102453312X13376952196412
Journal:
HEMATOLOGY MANEY PUBLISHING
Volume:
17
Research Area:
Hematology
ISSN
ISI:000305275900005
Keywords :
Biomarkers, Anthracycline, Cardiotoxicity, Leukemia, Children
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.
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