Cardiotoxicity after anthracycline chemoteraphy in breast carcinoma: Effects on left ventricular ejection fraction, troponin I and neurohormonal assessment

BackgroundIt has been reported that recovery of left ventricular ejection fraction (LVEF) is associated with better prognosis in heart failure (HF) patients with reduced EF (rEF). However, change of LVEF has not yet been investigated in cases of HF with preserved EF (HFpEF).Methods and resultsConsecutive 1082 HFpEF patients, who had been admitted to hospital due to decompensated HF (EF >50% at the first LVEF assessment at discharge), were enrolled, and LVEF was reassessed within 6 months in the outpatient setting (second LVEF assessment). Among the HFpEF patients, LVEF of 758 patients remained above 50% (pEF group), 138 patients had LVEF of 40%–49% (midrange EF, mrEF group) and 186 patients had LVEF of less than 40% (rEF group). In the multivariable logistic regression analysis, younger age and presence of higher levels of troponin I were predictors of rEF (worsened HFpEF). In the Kaplan-Meier analysis, the cardiac event rate of the groups progressively increased from pEF, mrEF to rEF (log-rank, p<0.001), whereas all-cause mortality did not significantly differ among the groups. In the multivariable Cox proportional hazard analysis, rEF (vs pEF) was not a predictor of all-cause mortality, but an independent predictor of increased cardiac event rates (HR 1.424, 95% CI 1.020 to 1.861, p=0.039).ConclusionAn initial assessment of LVEF and LVEF changes are important for deciding treatment and predicting prognosis in HFpEF patients. In addition, several confounding factors are associated with LVEF changes in worsened HFpEF patients.

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Association between left ventricular ejection fraction and Kawasaki disease shock syndrome

Cardiology in the Young ◽

10.1017/s1047951118002056 ◽

2019 ◽

Vol 29 (2) ◽

pp. 178-184 ◽

Cited By ~ 3

Author(s):

Huixian Qiu ◽

Chen Li ◽

Yuee He ◽

Fengfeng Weng ◽

Hongying Shi ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Kawasaki Disease ◽

Ejection Fraction ◽

Troponin I ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Control Group ◽

Albumin Concentration ◽

Ventricular Ejection Fraction

AbstractObjectiveThis study was performed to explore the clinical features of Kawasaki disease shock syndrome and analyse the association between the left ventricular ejection fraction and Kawasaki disease shock syndrome.MethodsWe retrospectively reviewed the medical records of all consecutive inpatients with Kawasaki disease at Wenzhou Medical University Second Affiliated Hospital and Yuying Children’s Hospital in Wenzhou, China from January 2009 to December 2016. We compared the clinical characteristics, laboratory data, and left ventricular ejection fraction between patients with and without Kawasaki disease shock syndrome and analysed the effect of the left ventricular ejection fraction on Kawasaki disease shock syndrome under different clinical conditions of Kawasaki disease.ResultsIn total, 1147 patients were diagnosed with Kawasaki disease. Of these 1147 patients, 17 were diagnosed with Kawasaki disease shock syndrome; 68 patients admitted to the hospital at the same time, ±2 weeks, with Kawasaki disease but without Kawasaki disease shock syndrome served as the control group. Compared with the control group, the Kawasaki disease shock syndrome group had a significantly higher incidence of coronary artery lesions, cardiac troponin I concentration, N-terminal prohormone of brain natriuretic peptide concentration, neutrophil count and ratio, alanine aminotransferase concentration, aspartate aminotransferase concentration, and C-reactive protein concentration and a significantly lower platelet count, serum albumin concentration, and left ventricular ejection fraction. A low left ventricular ejection fraction was associated with Kawasaki disease shock syndrome under different conditions of Kawasaki disease.ConclusionAmong patients with Kawasaki disease, cardiac injury is more likely in those with Kawasaki disease shock syndrome than without, and a low left ventricular ejection fraction may be associated with the development of Kawasaki disease shock syndrome.

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Factors Influencing Left Ventricular Ejection Fraction in patients with CMVD and OCAD

10.21203/rs.2.23558/v1 ◽

2020 ◽

Author(s):

Henry Anselmo Mayala ◽

Mafuru Magesa ◽

Abdalah Mkangala ◽

Mark Mayala ◽

Pedro Pallangyo ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Troponin I ◽

Negative Relationship ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Common Symptom ◽

Ventricular Ejection Fraction ◽

Significant Negative Relationship

Abstract Objective: The aim of our research was to evaluate the relationship involving LVEF, LDL, BNP, Troponin I and CFR, and to determine the predictors of LVEF in patients with CMVD and OCAD, and in patients with CMVD. Results: The mean age was 58.5±12.5 years. Approximately 60% of the patients were women. Chest pain was the common symptom in both conditions around 45% followed by chest tightness which was 25%. In patients OCAD and CMVD we found low density lipoprotein-c (LDL-c) had significant inverse relationship with LVEF (r= -0.323, P= 0.042), LVEF also had significant negative relationship with BNP, and Troponin-I. While a significant direct relationship turned out to be observed linking LVEF with CFR (r= 0.422, P=0.007). Left ventricular ejection fraction had significant negative relationship with LDL-C (r= -0.489, P=0.029), and BNP (r= -0.472, P=0.035) in patients with OCAD only. Age, blood pressure, lipid levels, RDW, HbA1C, symptoms, NYHA classification, Alcohol drinking, hypertension, diabetes mellitus, troponin levels and BNP were the predictors for LVEF in CMVD patients. We depicted a strong negative relationship between LVEF and biomarkers (LDL-c, BNP, Troponin-I), with a significant positive association between LVEF and CFR.

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Minor Increases in Plasma Troponin I Predict Decreased Left Ventricular Ejection Fraction after High-Dose Chemotherapy

Clinical Chemistry ◽

10.1373/49.2.248 ◽

2003 ◽

Vol 49 (2) ◽

pp. 248-252 ◽

Cited By ~ 81

Author(s):

Maria Teresa Sandri ◽

Daniela Cardinale ◽

Laura Zorzino ◽

Rita Passerini ◽

Paola Lentati ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Troponin I ◽

High Dose Chemotherapy ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

High Dose ◽

Roc Curve Analysis ◽

Ventricular Ejection Fraction

Abstract Background: Increased cardiac troponin I (cTnI) in patients treated with high-dose chemotherapy (HDCT) for aggressive malignancy has been proposed as an early marker of late HDCT-induced cardiac dysfunction. We investigated whether cTnI measured by the Stratus CS (Dade Behring) would allow detection of minimal cTnI increases in patients treated with HDCT. Methods: Plasma cTnI concentrations were determined in 179 consecutive patients before HDCT, at the end of the treatment, and after 12, 24, 36, and 72 h. Cardiac function was explored by echocardiography, and left ventricular ejection fraction (LVEF) was recorded during follow-up. The greatest variation in LVEF from the baseline value was used as a measure of cardiac damage. Results: In 99 healthy volunteers, the 99th percentile was at 0.07 μg/L. On the basis of ROC curve analysis (area under the curve, 0.89), a cutoff of 0.08 μg/L was chosen (sensitivity, 82%; specificity, 77%). cTnI ≥0.08 μg/L occurred in 57 patients (32%) with echocardiographic monitoring revealing a mean decrease in LVEF of 18%. In comparison, the group of cTnI-negative patients had a mean decrease in LVEF of 2.5% (P <0.001). Conclusions: Plasma cTnI, as measured with the Stratus CS, can detect minor myocardial injury in patients treated with HDCT.

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