Current Possibilities of Early Detection of Cardiotoxicity of Cytostatic Treatment

Czech version

Authors: Katarína Balážová ¹; Daniela Kubincová ²
Authors‘ workplace: Oddelenie všeobecnej kardiológie, Stredoslovenský ústav srdcových a cievnych chorôb a. s., Banská Bystrica, Slovenská republika ¹; Hematologické oddelenie, Fakultná nemocnica s poliklinikou F. D. Roosevelta, Banská Bystrica, Slovenská republika ²
Published in: Klin Onkol 2020; 33(3): 208-213
Category: Original Articles
doi: https://doi.org/10.14735/amko2020208

Overview

Background: Due to growing long-term survival rate of oncologic patients, there is increased interest in cardiotoxicity of oncologic treatment among medical professionals. It is concerning both paediatric and adult patients. When prescribing oncologic treatment, there should be focus on the efficacy and safety of the used drugs. Nowadays, the main problem is early diagnosis of cardiotoxicity.

Purpose: In our work we wanted to investigate whether the increase in biomarkers after the cytostatic therapy with anthracyclines can predict further increase in the left ventricular volume and decrease of the left ventricular ejection fraction.

Materials and methods: We were monitoring 36 patients with the diagnosis of non-Hodgkin’s lymphoma who received therapy with anthracyclines. After the therapy we were measuring the cardiac biomarkers NT-proBNP and high-sensitivity troponin I and performed echocardiography.

Results: In our group of patients there is a statistically significant correlation between increased levels of troponin I, NT-proBNP and increment of the left ventricular volume measured before the treatment and 3 months after the treatment. There is also a significant inverse correlation between the left ventricular volume and left ventricular ejection fraction. There was no relationship between higher cumulative doses of anthracyclines and the increment of the left ventricular volume. There is a significant correlation between higher cumulative doses of anthracyclines and higher levels of troponin I.

Conclusion: The measurement of biomarkers troponin I and NT-proBNP should be considered for an early diagnosis of cardiotoxicity in oncologic patients. Echocardiography is also beneficial for the diagnosis in these patients. All efforts after the diagnosis should be focused on the therapy with cardioprotective drugs, which can prevent the development of severe heart failure.

Keywords:

Chemotherapy – cardiotoxicity – anthracyclines – cardiomyopathy – heart failure – oncologic treatment

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