Division of Cardiovascular Medicine, Vanderbilt University, Nashville, Tennessee.
Division of Cardiovascular Medicine, Vanderbilt University, Nashville, Tennessee.
J Card Fail. 2016 Jun;22(6):433-8. doi: 10.1016/j.cardfail.2016.04.003. Epub 2016 Apr 11.
Anthracycline chemotherapy is associated with an increased risk of developing heart failure (HF). The current standard for detecting HF or cardiotoxicity during chemotherapy involves episodic cardiac imaging typically at prescribed intervals and there are limited studies examining techniques beyond measuring left ventricular (LV) function. This study explores whether cardiac biomarkers troponin I (TnI) and B-type natriuretic peptide (BNP) could be part of a screening strategy for early detection of the development of cardiotoxicity in patients undergoing anthracycline chemotherapy.
Patients were enrolled from a single medical center. Cardiac biomarkers (TnI, BNP) were measured before and within 24 hours after completion of anthracycline administration for each cycle of therapy. Cardiac imaging was obtained at baseline and at completion of chemotherapy (commonly at 6 or 12 months) or based on clinical suspicion of a cardiac event. Of the enrolled 109 patients, 11 (10.1%) experienced cardiac events; all of these patients had at least 1 BNP value >100 pg/mL before the cardiac event. Significant reduction in LV ejection fraction as defined for cardiotoxicity occurred in only 3 of 10 patients (30%) with a cardiac event.
The use of cardiac biomarkers, particularly BNP, may allow early detection of cardiotoxicity related to anthracycline chemotherapy.
蒽环类化疗会增加心力衰竭（HF）的发病风险。目前，化疗期间检测 HF 或心脏毒性的标准方法是定期进行心脏成像检查，但很少有研究探讨除左心室（LV）功能测量以外的技术。本研究旨在探讨心脏标志物肌钙蛋白 I（TnI）和 B 型利钠肽（BNP）是否可作为一种筛查策略，用于早期发现接受蒽环类化疗的患者心脏毒性的发展。
患者来自单家医疗中心。在每个化疗周期的蒽环类药物给药前后 24 小时内，测量心脏标志物（TnI、BNP）。在基线时和化疗结束时（通常在 6 或 12 个月时）或根据心脏事件的临床可疑情况进行心脏成像。在入组的 109 例患者中，有 11 例（10.1%）发生了心脏事件；所有这些患者在心脏事件发生前均至少有 1 次 BNP 值>100pg/mL。在发生心脏事件的 10 例患者中，仅 3 例（30%）出现了定义为心脏毒性的 LV 射血分数明显下降。
心脏标志物，尤其是 BNP 的使用可能有助于早期发现与蒽环类化疗相关的心脏毒性。
