A1 Refereed original research article in a scientific journal

Cardiac biomarkers indicate a need for sensitive cardiac imaging among long-term childhood cancer survivors exposed to anthracyclines




AuthorsYlänen K., Poutanen T., Savukoski T., Eerola A., Vettenranta K.

PublisherWiley-Blackwell Publishing Ltd.

Publication year2015

JournalActa Paediatrica

Journal name in sourceActa Paediatrica, International Journal of Paediatrics

Volume104

Issue3

First page 313

Last page319

Number of pages7

ISSN1651-2227

DOIhttps://doi.org/10.1111/apa.12862

Web address http://api.elsevier.com/content/abstract/scopus_id:84923204872


Abstract

Aim The role that plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponins T (cTnT) and I (cTnI) play in supplementing imaging to screen for cardiac late effects remains controversial and the impact of high-sensitivity cTnT and troponin-specific autoantibodies (cTnAAbs) remains unexplored. We studied the role of cardiac biomarkers as indicators of the late effects of anthracyclines among childhood cancer survivors. Methods We measured NT-proBNP, cTnT, high-sensitivity cTnT, cTnI and cTnAAbs in 76 childhood cancer survivors at a median of 9 years after primary diagnosis. The survivors underwent conventional and real-time three-dimensional echocardiography and 62 underwent cardiac magnetic resonance imaging (MRI). Results Of the survivors, four (5.3%) without risk factors for cardiotoxicity were cTnAAb-positive with an impaired cardiac function in MRI. Another four (5.3%) had an abnormal NT-proBNP level associated with an abnormal cardiac function and risk factors for cardiotoxicity. None showed measurable cardiac troponins, determined by the three different methods, with even the high-sensitivity cTnT-levels remaining normal. Conclusion Elevated plasma NT-proBNP or cTnAAbs indicated that childhood cancer survivors benefitted from being evaluated with modern imaging, despite normal function in conventional echocardiography. However, troponins did not seem to provide additional information on the late cardiotoxicity of anthracyclines.




Last updated on 2024-26-11 at 18:24