Troponins and Natriuretic Peptides in Cardio-Oncology Patients-Data From the ECoR Registry.

NT-proBNP cancer cardio-oncology cardiomyopathy cardiotoxicity troponin

Journal

Frontiers in pharmacology
ISSN: 1663-9812
Titre abrégé: Front Pharmacol
Pays: Switzerland
ID NLM: 101548923

Informations de publication

Date de publication:
2020
Historique:
received: 01 03 2020
accepted: 04 05 2020
entrez: 9 6 2020
pubmed: 9 6 2020
medline: 9 6 2020
Statut: epublish

Résumé

The long-term survival of cancer patients has significantly improved over the past years. Despite their therapeutic efficacy, various cancer therapies are associated with cardiotoxicity. Therefore, timely detection of cardiotoxic adverse events is crucial. However, the clinical assessment of myocardial damage caused by cancer therapy remains difficult. This retrospective study was performed to evaluate the diagnostic value of cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for monitoring cancer therapy-induced cardiomyopathy. A total of 485 cancer patients referred to our cardio-oncology unit between July 2018 and January 2020 were selected from our In cross-sectional data, elevated NT-proBNP was associated with reduced LVEF and pathological GLS in the total cohort. A total of 116 patients had serial LVEF and biomarker measurements, and changes in NT-proBNP and troponin correlated with changes in LVEF during follow-up investigations. Similar to the total cohort, a subgroup of patients treated for malignant melanoma showed a correlation between the change in cTnI and the change in LVEF. In a subgroup analysis of patients undergoing breast cancer therapy, a correlation between the change in NT-proBNP and the change in LVEF could be detected. Thirty patients presented with chemotherapy-induced cardiomyopathy, defined as a significant LVEF decrease (> 10%) to a value below 50%. The number of patients with increased cTnI and NT-proBNP was significantly higher in patients with chemotherapy-induced cardiomyopathy than in patients without cardiotoxicity. Patients with positive cTnI and NT-proBNP were more likely to have a history of coronary heart disease, atrial fibrillation, and arterial hypertension. Our data suggest that cardiac biomarkers play an important role in the detection of cancer therapy-induced cardiotoxicity. Larger systematic assessment in prospective cohorts is mandatory.

Sections du résumé

BACKGROUND BACKGROUND
The long-term survival of cancer patients has significantly improved over the past years. Despite their therapeutic efficacy, various cancer therapies are associated with cardiotoxicity. Therefore, timely detection of cardiotoxic adverse events is crucial. However, the clinical assessment of myocardial damage caused by cancer therapy remains difficult.
METHODS METHODS
This retrospective study was performed to evaluate the diagnostic value of cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for monitoring cancer therapy-induced cardiomyopathy. A total of 485 cancer patients referred to our cardio-oncology unit between July 2018 and January 2020 were selected from our
RESULTS RESULTS
In cross-sectional data, elevated NT-proBNP was associated with reduced LVEF and pathological GLS in the total cohort. A total of 116 patients had serial LVEF and biomarker measurements, and changes in NT-proBNP and troponin correlated with changes in LVEF during follow-up investigations. Similar to the total cohort, a subgroup of patients treated for malignant melanoma showed a correlation between the change in cTnI and the change in LVEF. In a subgroup analysis of patients undergoing breast cancer therapy, a correlation between the change in NT-proBNP and the change in LVEF could be detected. Thirty patients presented with chemotherapy-induced cardiomyopathy, defined as a significant LVEF decrease (> 10%) to a value below 50%. The number of patients with increased cTnI and NT-proBNP was significantly higher in patients with chemotherapy-induced cardiomyopathy than in patients without cardiotoxicity. Patients with positive cTnI and NT-proBNP were more likely to have a history of coronary heart disease, atrial fibrillation, and arterial hypertension.
CONCLUSION CONCLUSIONS
Our data suggest that cardiac biomarkers play an important role in the detection of cancer therapy-induced cardiotoxicity. Larger systematic assessment in prospective cohorts is mandatory.

Identifiants

pubmed: 32508657
doi: 10.3389/fphar.2020.00740
pmc: PMC7248256
doi:

Types de publication

Journal Article

Langues

eng

Pagination

740

Informations de copyright

Copyright © 2020 Hinrichs, Mrotzek, Mincu, Pohl, Röll, Michel, Mahabadi, Al-Rashid, Totzeck and Rassaf.

Références

Int J Cardiol. 2008 Feb 29;124(2):193-7
pubmed: 17433473
ESC Heart Fail. 2019 Aug;6(4):856-862
pubmed: 31297946
J Intern Med. 2002 Mar;251(3):228-34
pubmed: 11886482
Int J Cardiol Heart Vasc. 2019 Sep 07;25:100420
pubmed: 31517036
Cancer. 1992 Mar 15;69(6):1492-7
pubmed: 1531780
Eur J Cancer. 2018 May;94:126-137
pubmed: 29567630
J Thorac Dis. 2018 Dec;10(Suppl 35):S4282-S4295
pubmed: 30701097
J Am Coll Cardiol. 2018 Apr 24;71(16):1755-1764
pubmed: 29567210
Eur Heart J. 2016 Sep 21;37(36):2739-2740
pubmed: 27694539
Semin Oncol. 2019 Dec;46(6):408-413
pubmed: 31784042
Eur J Prev Cardiol. 2018 Mar;25(5):482-494
pubmed: 29376753
Saudi Med J. 2005 Aug;26(8):1197-202
pubmed: 16127512
Circulation. 2015 Jun 2;131(22):1981-8
pubmed: 25948538
J Am Coll Cardiol. 2007 Oct 9;50(15):1435-41
pubmed: 17919562
Int J Cardiol. 2019 Apr 1;280:163-175
pubmed: 30661849
Cancer Invest. 2001;19(4):352-9
pubmed: 11405175
Cancer Chemother Pharmacol. 2017 Oct;80(4):787-798
pubmed: 28856562
Int J Cardiol. 2006 Apr 4;108(2):212-5
pubmed: 16290101
Am Heart J. 2009 Oct;158(4):673-9
pubmed: 19781430
J Thorac Dis. 2018 Dec;10(Suppl 35):S4386-S4390
pubmed: 30701105
Circulation. 2006 Dec 5;114(23):2474-81
pubmed: 17101852
Heart. 2015 Dec;101(23):1874-80
pubmed: 26416836
Eur Heart J. 2020 May 7;41(18):1720-1729
pubmed: 32016393
Circulation. 2004 Jun 8;109(22):2749-54
pubmed: 15148277
Am J Cardiol. 2011 May 1;107(9):1375-80
pubmed: 21371685
Ann Oncol. 2020 Feb;31(2):171-190
pubmed: 31959335
Eur Heart J. 2016 Sep 21;37(36):2768-2801
pubmed: 27567406
Eur Heart J Cardiovasc Imaging. 2017 May 1;18(8):930-936
pubmed: 28379383
Am Heart J. 1998 Aug;136(2):362-3
pubmed: 9704703
Eur J Heart Fail. 2016 Aug;18(8):891-975
pubmed: 27207191
J Am Coll Cardiol. 2017 Nov 14;70(20):2552-2565
pubmed: 29145955
J Am Coll Cardiol. 2017 Nov 14;70(20):2536-2551
pubmed: 29145954
Expert Rev Mol Diagn. 2017 Mar;17(3):245-256
pubmed: 28092472
Intern Emerg Med. 2012 Apr;7(2):113-31
pubmed: 22161318
J Am Coll Cardiol. 2017 Oct 31;70(18):2226-2236
pubmed: 29073949
J Am Heart Assoc. 2017 Aug 10;6(8):
pubmed: 28862931
Curr Med Chem. 2012;19(16):2485-96
pubmed: 22489719
Curr Treat Options Cardiovasc Med. 2008 Dec;10(6):486-95
pubmed: 19026179
Curr Treat Options Cardiovasc Med. 2018 Jun 19;20(7):55
pubmed: 29923056
Nat Rev Cardiol. 2013 Nov;10(11):623-34
pubmed: 23979214
Circ Cardiovasc Imaging. 2012 Sep 1;5(5):596-603
pubmed: 22744937
Exp Clin Cardiol. 2006 Summer;11(2):99-101
pubmed: 18651043
J Oncol Pharm Pract. 2016 Apr;22(2):242-7
pubmed: 25567518
Eur Heart J Cardiovasc Imaging. 2017 Dec 1;18(12):1301-1310
pubmed: 29045589
Circulation. 1997 Apr 15;95(8):2053-9
pubmed: 9133515
Am Heart J. 2001 Mar;141(3):367-74
pubmed: 11231433
Oncologist. 2019 Nov;24(11):e1034-e1043
pubmed: 31064888
J Mol Cell Cardiol. 1989 Dec;21(12):1349-53
pubmed: 2632816
Pediatr Blood Cancer. 2007 Nov;49(6):812-6
pubmed: 17171687
Oncol Lett. 2016 May;11(5):3483-3492
pubmed: 27123140
Eur Heart J. 2014 Sep 7;35(34):2303-11
pubmed: 24842285
J Am Coll Cardiol. 2000 Aug;36(2):517-22
pubmed: 10933366
J Am Soc Echocardiogr. 2019 Jan;32(1):1-64
pubmed: 30282592
Semin Oncol. 2013 Apr;40(2):186-98
pubmed: 23540744
Clin Chem. 2005 Aug;51(8):1405-10
pubmed: 15932966
J Lab Clin Med. 2005 Apr;145(4):212-20
pubmed: 15962840

Auteurs

Lena Hinrichs (L)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Simone Maria Mrotzek (SM)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Raluca-Ileana Mincu (RI)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Julia Pohl (J)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Alina Röll (A)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Lars Michel (L)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Amir Abbas Mahabadi (AA)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Fadi Al-Rashid (F)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Matthias Totzeck (M)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Tienush Rassaf (T)

Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen, Germany.

Classifications MeSH