Serum troponin T levels and echocardiographic evaluation in children treated with doxorubicin.
OBJECTIVE
We investigated the usefulness of serum cardiac Troponin T (cTnT) to detect doxorubicin related cardiotoxicity as a non-invasive and reliable method.


METHODS
Twenty-four patients who received doxorubicin for their solid tumors at cumulative doses of 400 mg/m(2) or higher, between June 1982 and August 2000, were included in this study. None of them had clinical signs or symptoms of cardiotoxicity. The age range was 3-31 years (median 14), and male to female ratio was 14/10. The systolic and diastolic cardiac functions were evaluated by two-dimensional, M-mode, and Doppler echocardiography. Serum cTnT levels were measured by a third generation immunoassay method and the lowest detectable level was 0.010 ng/ml.


RESULTS
The cumulative doxorubicin doses were at the range of 400 and 840 mg/m(2) (median 480). The time past from the last doxorubicin dose was 1-168 months (median 12). All of the patients had normal chest X-rays, electrocardiograms, and nine patients (37.5%) had abnormal systolic or diastolic cardiac function parameters. The median cumulative doxorubicin doses of the patients with normal and abnormal echocardiographic parameters were 480 and 440 mg/m(2), respectively. Serum cTnT values of 21 patients were below the detection limit (< 0.010 ng/ml). There was no statistical difference between serum cTnT levels of the patients with normal and abnormal echocardiographic findings (P = 0.376).


CONCLUSIONS
No correlation was found between serum cTnT values, cumulative doxorubicin doses, and systolic or diastolic cardiac functions. We can conclude that echocardiographic follow-up is more reliable than serum cTnT levels for detecting subclinical cardiac toxicity.
Kismet
Erol
E
Department of Pediatric Oncology, Gülhane Military Medical Academy, Etlik, Ankara, Turkey. erolkismet@cocukdoktorunuz.com
Varan
Ali
A
Ayabakan
Canan
C
Alehan
Dursun
D
Portakal
Oytun
O
Büyükpamukçu
Münevver
M
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use / Q000633:toxicity*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004317:Doxorubicin / Q000627:therapeutic use / Q000633:toxicity*; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000139:chemically induced / Q000175:diagnosis; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D020107:Troponin T / Q000097:blood*
D000970:Antineoplastic Agents; D015415:Biomarkers; D020107:Troponin T; D004317:Doxorubicin