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Biomarkers and early detection of late onset anthracycline-induced cardiotoxicity in children

机译:生物标志物和早期发现蒽环类药物引起的儿童心脏毒性的早期发现

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Background: The main strategy for minimizing anthracycline cardiotoxicity is early detection of high-risk patients. Aim of the study: To investigate the role of cardiac biomarkers; cardiac troponin T (cTnT) and N-terminal probrain natriuretic peptide (NT-pro-BNP), and tissue Doppler imaging (TDI), as early predictors of chronic cardiotoxicity in survivors of acute leukemia. Patients and methods: We carried a retrospective study on 50 asymptomatic survivors of acute leukemia who received anthracycline in their treatment protocols. All patients underwent blood sampling to determine the levels of NT-pro-BNP and cTnT along with conventional echocardiography and TDI. Results: None had abnormal cTnT levels. About 20% had abnormal NT-pro-BNP levels. Diastolic dysfunction of the left ventricle was the most significant in conventional echocardiography. TDI was superior as it detected myocardial affection in 10% more than echo. TDI demonstrated global myocardial damage with significant aberrations in peak myocardial velocities and ratios. Conclusions: NT-pro-BNP can be used as a sensitive cardiac biomarker in monitoring of anthracyclineinduced cardiotoxicity. Follow up is essential to validate the role of NT-pro-BNP as an early marker for late onset anthracycline-induced cardiotoxicity. Tissue Doppler is marvelous as it could detect early cardiac dysfunction even in those with normal study by conventional echocardiography.
机译:背景:减少蒽环类药物心脏毒性的主要策略是及早发现高危患者。研究的目的:研究心脏生物标志物的作用。心肌肌钙蛋白T(cTnT)和N末端脑钠肽(NT-pro-BNP)和组织多普勒成像(TDI),可作为急性白血病幸存者慢性心脏毒性的早期预测指标。患者和方法:我们对50名无症状急性白血病幸存者进行了回顾性研究,他们在治疗方案中接受了蒽环类药物。所有患者均接受血液采样以确定NT-pro-BNP和cTnT的水平以及常规超声心动图和TDI。结果:没有人的cTnT水平异常。大约20%的NT-pro-BNP水平异常。在常规超声心动图检查中,左心室舒张功能障碍最为明显。 TDI优越,因为它检测到的心肌影响比回声多10%。 TDI表现出整体性心肌损害,其最大峰值速度和比率存在明显偏差。结论:NT-pro-BNP可作为监测蒽环类药物致心脏毒性的敏感心脏生物标志物。随访对于验证NT-pro-BNP作为早期蒽环类药物引起的心脏毒性的早期标志物的作用至关重要。组织多普勒奇妙之处在于,即使在常规超声心动图检查正常的患者中,它也能检测出早期心脏功能障碍。

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