title: Use of cardiac markers for monitoring of doxorubixin-induced cardiotoxicity in children with cancer.
abstract: The aim of this study was to evaluate N-terminal probrain natriuretic peptides (NT-pro-BNP), cardiac troponin T, and creatinine kinase, MB isoenzyme (CK-MB) in the determination of subclinical left ventricular (LV) dysfunction by echocardiography in patients treated with doxorubicin. We performed a cross-sectional case study of systolic, diastolic function and tissue Doppler imaging by echocardiography in children with cancer who received a certain cumulative dose of doxorubicin. Blood levels for NT-pro-BNP, cardiac troponin T, and CK-MB were analyzed within 6 hours of the cardiac study. Of 30 patients, 5 (16.7%) had LV dysfunction with an abnormally high NT-pro-BNP level of 363 ± 78 pg/mL, whereas patients with normal LV function had an NT-pro-BNP level of 148 ± 173 pg/mL (P = 0.012). The NT-pro-BNP level not only inversely correlated with fractional shortening (r = -0.43, P = 0.017) and ejection fraction (r = - 0.45, P = 0.013) but also correlated with mitral deceleration time ( r = 0.41, P = 0.021) and a cumulative dose of doxorubicin (r = 0.44, P = 0.014). For tissue Doppler imaging, NT-pro-BNP correlated with a peak systolic velocity at the myocardial segment (Sm) (r = -0.40, P = 0.027). NT-pro-BNP is a sensitive test and has a moderate relationship with the LV systolic and diastolic function, thus making it a useful cardiac marker for the monitoring of early anthracycline cardiotoxicity.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. ypongpro@med.cmu.ac.th
authors.forename: Yupada
authors.initials: Y
authors.lastname: Pongprot
authors.forename: Rekwan
authors.initials: R
authors.lastname: Sittiwangkul
authors.forename: Pimlak
authors.initials: P
authors.lastname: Charoenkwan
authors.forename: Suchaya
authors.initials: S
authors.lastname: Silvilairat
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D052279:Creatine Kinase, MB Form / Q000097:blood*; D003430:Cross-Sectional Studies; D003971:Diastole / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D016903:Drug Monitoring / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*; D010446:Peptide Fragments / Q000097:blood*; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole / Q000187:drug effects; D020107:Troponin T / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D004317:Doxorubicin; D052279:Creatine Kinase, MB Form