Cardiotoxicity of antracycline treatment in the light of new biochemical diagnostic options


Authors: D. Urbanová ;  B. Mladosievičová
Authors‘ workplace: Ústav patologickej fyziológie, Oddelenie klinickej patofyziológie Lekárskej fakulty UK Bratislava, Slovenská republika, prednosta doc. MUDr. Marián Bernadič, CSc., mim. prof.
Published in: Vnitř Lék 2007; 53(6): 669-677
Category: Reviews

Overview

Oncologic patients often receive treatment which is potentially cardiotoxic. Cardiotoxic complications range from fairly mild (relatively benign arrhythmias) to life threatening conditions (ischemia/myocardial infarction, heart failure, cardiomyopathy). The toxic effect of chemotherapy drugs may impair the integrity of the sarcomere, cause the release of bioactive substances into both tissues and the circulatory system and, consequently, cause necrosis/apoptosis of myocytes. A marker of the scope and severity of damage to the myocardium can be assessed by measuring the levels of cardiac markers in the serum. Cardiologic research is currently focused on the identification of new biochemical markers with a high degree of specificity, sensitivity and predictive value that might be used in the timely detection of myocardial abnormalities. The informative value of currently measured cardiac markers (myoglobin, CK-MB mass, CK-MB, and partly CK) is insufficient. There is growing evidence of the usefulness of natriuretic peptides and cardiac troponins in the diagnosing and monitoring of early and late, clinical and subclinical cardiotoxiticy resulting from anti-tumour therapy. The article summarises clinical studies concerning the diagnosis and monitoring of cardiotoxicity with the use of natriuretic peptides and cardiac troponins in former oncological patients.

Key words:
cardiotoxicity – anthracyclines – cardiac troponins – natriuretic peptides


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