Jackowska Teresa, Wasilewski Robert
Katedra i Klinika Pediatrii, Hematologii i Onkologii, Akademia Medyczna, ul. Marszałkowska 24, 00-576 Warszawa, Poland.
Med Wieku Rozwoj. 2006 Jul-Sep;10(3 Pt 1):767-74.
Cardiotoxicity of anthracydines is a serious clinical problem, and it is the main factor limiting their wide use, despite the recognized antineoplastic properties of anthracyclines. Early detection of adverse effects of anthracyclines is therefore very important for proper prevention of congestive heart failure. Current methods of detection of cardiotoxic activity of anthracyclines (ECG, ECHO) are suitable only for fully symptomatic cases. In subclinical damage of the heart these methods are insufficient. Measurement of NT-proBNP has been shown to be a sensitive indicator of cardiac abnormalities. Concentration of NT-proBNP in blood increases very early in response to volume overload of the ventricles of the heart seen in congestive heart failure. Chemical and physical features of NT-proBNP: long half-time in blood, low requirements for sample collection and storage conditions and easy availability of kits for its measurements make NT-proBNP a very good marker of subclinical postanthracycline congestive heart failure.
蒽环类药物的心脏毒性是一个严重的临床问题，尽管蒽环类药物具有公认的抗肿瘤特性，但它是限制其广泛应用的主要因素。因此，早期检测蒽环类药物的不良反应对于正确预防充血性心力衰竭非常重要。目前检测蒽环类药物心脏毒性活性的方法（心电图、超声心动图）仅适用于症状完全明显的病例。在心脏亚临床损伤中，这些方法并不充分。NT-proBNP的测量已被证明是心脏异常的敏感指标。在充血性心力衰竭中，心脏心室容量超负荷时，血液中NT-proBNP的浓度会很早就升高。NT-proBNP的化学和物理特性：在血液中的半衰期长、对样本采集和储存条件要求低以及测量试剂盒易于获得，使得NT-proBNP成为蒽环类药物治疗后亚临床充血性心力衰竭的良好标志物。
