title: Cardiac troponin I in patients with hematologic malignancies.
abstract: BACKGROUND
  The cardiac isoform of troponin I (cTnI) is a myofibrillar protein highly specific for myocardial injury. We used a recently developed new-generation immunoassay with high analytical sensitivity to measure cTnI in patients diagnosed with hematologic malignancies, before chemotherapy and after an intermediate cumulative dose of anthracyclines. We hypothesized that measurement of cTnI with this sensitive method would provide evidence of myocardial injury in these patients.
  
  
  METHODS
  Sera from 115 individuals (60 healthy controls, 25 anthracycline-naive patients and 30 patients treated with intermediate cumulative doses of anthracyclines) were assessed for cTnI, creatine kinase MB (CKMB) mass and myoglobin. Radionuclide left ventricular ejection fraction (LVEF) was also determined.
  
  
  RESULTS
  Using this sensitive assay, detectable concentrations of cTnl were measured in the healthy population [mean, 19.5 pg/ml, 95% confidence interval (CI) 13.5-25.5 pg/ml]. Anthracycline-naive patients had cTnI mean values (36.5 pg/ml, 95% CI 25.1-47.9 pg/ml) that were significantly (P < 0.01) greater than those in the control group. cTnI was significantly (P < 0.00001) increased in anthracycline-treated patients (76.4 pg/ml, 95% CI 67.0-85.8 pg/ml) compared with both the anthracycline-naive patients and the controls. CKMB, myoglobin and LVEF were within the normal range in all patients.
  
  
  CONCLUSIONS
  These data provide evidence for cardiac involvement in patients with hematological malignancies before and during the course of anthracycline chemotherapy. They suggest that detection of myocardial injury may be facilitated by measurement of cTnI with a highly sensitive assay.
authors.affiliation: Department of Cardiology, INSERM U-390, Montpellier, France.
authors.forename: E
authors.initials: E
authors.lastname: Missov
authors.forename: C
authors.initials: C
authors.lastname: Calzolari
authors.forename: J M
authors.initials: JM
authors.lastname: Davy
authors.forename: F
authors.initials: F
authors.lastname: Leclercq
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: B
authors.initials: B
authors.lastname: Pau
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D009202:Cardiomyopathies / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D003402:Creatine Kinase / Q000032:analysis / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006321:Heart / Q000187:drug effects; D019337:Hematologic Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009211:Myoglobin / Q000032:analysis / Q000187:drug effects; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000187:drug effects; D019210:Troponin I / Q000032:analysis / Q000097:blood*
chemical_list: D000903:Antibiotics, Antineoplastic; D015415:Biomarkers; D009211:Myoglobin; D019210:Troponin I; D003402:Creatine Kinase