Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015:2015:513219.
doi: 10.1155/2015/513219. Epub 2015 Apr 16.

NT-proBNP as early marker of subclinical late cardiotoxicity after doxorubicin therapy and mediastinal irradiation in childhood cancer survivors

Amal Zidan  1 , Laila M Sherief  2 , Amera El-sheikh  1 , Safaa H Saleh  2 , Doaa A Shahbah  2 , Naglaa M Kamal  3 , Hanan S Sherbiny  2 , Heba Ahmad  1
Affiliations

NT-proBNP as early marker of subclinical late cardiotoxicity after doxorubicin therapy and mediastinal irradiation in childhood cancer survivors

Amal Zidan et al. Dis Markers. 2015.

Abstract

Background: Childhood cancer survivors treated with anthracyclines and mediastinal irradiation are at risk for late onset cardiotoxicity.

Aims of the study: To assess the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) as early predictors of late onset cardiotoxicity in asymptomatic survivors of childhood cancer treated with doxorubicin with or without mediastinal irradiation.

Methods: A cross-sectional study on 58 asymptomatic survivors of childhood cancer who received doxorubicin in their treatment protocols and 32 asymptomatic Hodgkin's lymphoma survivors who received anthracycline and mediastinal irradiation. Levels of NT-proBNP, TDI, and conventional echocardiography were determined.

Results: Thirty percent of survivors had abnormal NT-proBNP levels. It was significantly related to age at diagnosis, duration of follow-up, and cumulative dose of doxorubicin. TDI detected myocardial affection in 20% more than conventional echocardiography. Furthermore, abnormalities in TDI and NT-pro-BNP levels were more common in Hodgkin lymphoma survivors receiving both chemotherapy and radiotherapy.

Conclusions: TDI could detect early cardiac dysfunction even in those with normal conventional echocardiography. Measurement of NT-proBNP represents an interesting strategy for detecting subclinical cardiotoxicity. We recommend prospective and multicenter studies to validate the role of NT-proBNP as an early marker for late onset doxorubicin-induced cardiotoxicity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The correlation between NT-proBNP and age of patients.
Figure 2
Figure 2
The correlation between NT-proBNP and duration of follow-up.
Figure 3
Figure 3
The correlation between NT-proBNP and cumulative dose of anthracycline.
Figure 4
Figure 4
The correlation between diastolic function by TDI functions (E/E′) and cumulative dose of anthracycline.
Figure 5
Figure 5
The correlation between proBNP and diastolic functions (E/E′).
Figure 6
Figure 6
The correlation between NT-proBNP and RV systolic functions by TDI functions (S′).
Figure 7
Figure 7
The correlation between NT-proBNP and LV systolic functions by TDI functions (S′).
Figure 8
Figure 8
Relation between TDI and group with abnormal NT-proBNP and those with normal NT-proBNP.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Gill S. E., Savage K., Wysham W. Z., Blackhurst D. W., Winter W. E., Puls L. E. Continuing routine cardiac surveillance in long-term use of pegylated liposomal doxorubicin: is it necessary? Gynecologic Oncology. 2013;129(3):544–547. doi: 10.1016/j.ygyno.2013.03.012. - DOI - PubMed
    1. Kremer L. C. M., van der Pal H. J. H., Offringa M., van Dalen E. C., Voûte P. A. Frequency and risk factors of subclinical cardiotoxicity after anthracycline therapy in children: a systematic review. Annals of Oncology. 2002;13(6):819–829. doi: 10.1093/annonc/mdf167. - DOI - PubMed
    1. Van Der Pal H. J., Van Dalen E. C., Hauptmann M., et al. Cardiac function in 5-year survivors of childhood cancer: a long-term follow-up study. Archives of Internal Medicine. 2010;170(14):1247–1255. doi: 10.1001/archinternmed.2010.233. - DOI - PubMed
    1. Kremer L. C. M., van Dalen E. C., Offringa M., Voûte P. A. Frequency and risk factors of anthracycline-induced clinical heart failure in children: a systematic review. Annals of Oncology. 2002;13(4):503–512. doi: 10.1093/annonc/mdf118. - DOI - PubMed
    1. Lipshultz S. E., Alvarez J. A., Scully R. E. Anthracycline associated cardiotoxicity in survivors of childhood cancer. Heart. 2008;94(4):525–533. doi: 10.1136/hrt.2007.136093. - DOI - PubMed

Publication types