title: Use of biomarkers for the assessment of chemotherapy-induced cardiac toxicity.
abstract: OBJECTIVE
  To review the evidence for the use of various biomarkers in the detection of chemotherapy associated cardiac damage.
  
  
  METHODS
  Pubmed.gov was queried using the search words chemotherapy and cardiac biomarkers with the filters of past 10years, humans, and English language. An emphasis was placed on obtaining primary research articles looking at the utility of biomarkers for the detection of chemotherapy-mediated cardiac injury.
  
  
  RESULTS
  Biomarkers may help identify patients undergoing treatment who are at high risk for cardiotoxicity and may assist in identification of a low risk cohort that does not necessitate continued intensive screening. cTn assays are the best studied biomarkers in this context and may represent a promising and potentially valuable modality for detecting cardiac toxicity in patients undergoing chemotherapy. Monitoring cTnI levels may provide information regarding the development of cardiac toxicity before left ventricular dysfunction becomes apparent on echocardiography or via clinical symptoms. A host of other biomarkers have been evaluated for their utility in the field of chemotherapy related cardiac toxicity with intermittent success; further trials are necessary to determine what role they may end up playing for prediction and prognostication in this setting.
  
  
  CONCLUSIONS
  Biomarkers represent an exciting potential complement or replacement for echocardiographic monitoring of chemotherapy related cardiac toxicity which may allow for earlier realization of the degree of cardiac damage occurring during treatment, creating the opportunity for more timely modulation of therapy.
authors.affiliation: Johns Hopkins University, Department of Medicine, Baltimore, MD 21287, USA. Electronic address: echris14@jhmi.edu.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Christenson
authors.affiliation: Johns Hopkins University, Department of Medicine, Baltimore, MD 21287, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: James
authors.affiliation: Johns Hopkins University, Department of Medicine, Baltimore, MD 21287, USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Johns Hopkins University, Department of Oncology, Baltimore, MD 21287, USA.
authors.forename: Ben H
authors.initials: BH
authors.lastname: Park
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D066126:Cardiotoxicity / Q000097:blood / Q000175:diagnosis; D006331:Heart Diseases / Q000097:blood* / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T; D020097:Natriuretic Peptide, Brain
keywords: Anthracyclines; Cardiac toxicity; Chemotherapy; Natriuretic peptides; Troponin