Annals of Oncology Advance Access originally published online on March 17, 2005
Annals of Oncology 2005 16(5):798-804; doi:10.1093/annonc/mdi152
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© 2005 European Society for Medical Oncology
cTnT can be a useful marker for early detection of anthracycline cardiotoxicity
Departments of 1 Medical Oncology and 2 Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
* Correspondence to: Dr S. Kilickap, Department of Medical Oncology, Hacettepe University Institute of Oncology, Sihhiye, 06100, Ankara, Turkey. Tel: +90-312-3052937; Fax: +90-312-3092905; Email: skilickap{at}yahoo.com
Background:: The level of serum cardiac troponin-T (cTnT) increases with myocardial damage. We sought to assess whether cTnT level could be a useful marker for the early detection of anthracycline cardiotoxicity.
Patients and methods:: Forty-one patients who had been scheduled to receive anthracycline-containing combination chemotherapy were included in the study. Serum cTnT levels were measured before (baseline) and after the first cycle of chemotherapy, and again, after the last cycle of chemotherapy. In all patients, the left ventricular ejection fraction (LVEF), fractional shortening (FS), early peak flow/atrial flow velocity (E/A) ratio, and the isovolemic relaxation time (IRT) were measured echocardiographically, both before and after the completion of chemotherapy.
Results:: LVEF and FS did not change in any patients. In 21 patients (49%), the E/A ratio decreased after therapy as compared to the pre-treatment values. The decrease in E/A ratio was more prominent in patients who were older than the mean age of our study group, which was 44 years. The post-treatment IRT was prolonged compared with the pretreatment IRT (94.0 ± 2.0 versus 85.6 ± 10.5 ms, respectively). cTnT levels after completion of therapy were elevated in 14 (34%) patients, and exceeded the upper limit of the normal range (>0.1 ng/ml) in only one patient. cTnT levels measured after completion of therapy were significantly higher, compared with those measured at baseline and after the first cycle of therapy. In the younger age group (
44 years old), there was a two-fold decrease in the E/A ratio in those patients whose cTnT levels increased during the therapy, when compared with those whose cTnT levels did not change (21% versus 43%, respectively).
Conclusion:: Increased serum cTnT level can be detected in the early stages of anthracycline therapy and it is associated with diastolic dysfunction of the left ventricle. Therefore, serum cTnT level could be a useful measure for early detection of anthracycline-induced cardiotoxicity.
Key words: anthracycline, cardiotoxicity, cardiac troponin-T, diastolic dysfunction
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