scholarly journals Multimodal assessment of acute cardiac toxicity induced by thoracic radiotherapy in cancer patients. Study protocol

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomás Merino ◽  
Mauricio P. Pinto ◽  
María Paz Orellana ◽  
Gonzalo Martinez ◽  
Marcelo Andía ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Troponin T ◽  
High Sensitivity ◽  
Premature Death ◽  
Circulating Endothelial Cells ◽  
Clinical Approach ◽  
Cardiac Damage ◽  
Curative Intent ◽  
Specificity And Sensitivity ◽  
Asymptomatic Patients

Abstract Background Today, cancer ranks as one of the leading causes of death. Despite the large number of novel available therapies, radiotherapy (RT) remains as the most effective non-surgical method to cure cancer patients. In fact, approximately 50% of all cancer patients receive some type of RT and among these 60% receive RT-treatment with a curative intent. However, as occurs with any other oncological therapy, RT treated patients may experience toxicity side effects that range from moderate to severe. Among these, cardiotoxicity represents a significant threat for premature death. Current methods evaluate cardiotoxic damage based on volumetric changes in the Left Ventricle Ejected Fraction (LVEF). Indeed, a 10% drop in LVEF is commonly used as indicator of cardiotoxicity. More recently, a number of novel techniques have been developed that significantly improve specificity and sensitivity of heart’s volumetric changes and early detection of cardiotoxicity even in asymptomatic patients. Among these, the Strain by Speckle Tracking (SST) is a technique based on echocardiographic analysis that accurately evaluates myocardial deformation during the cardiac cycle (ventricular and atrial function). Studies also suggest that Magnetic Resonance Imaging (MRI) is a high-resolution technique that enables a better visualization of acute cardiac damage. Methodology This protocol will evaluate changes in SST and MRI in cancer patients that received thoracic RT. Concomitantly, we will assess changes in serum biomarkers of cardiac damage in these patients, including: high-sensitivity cardiac Troponin-T (hscTnT), N-Terminal pro-Brain Natriuretic Peptide (NTproBNP) and Circulating Endothelial Cells (CECs), a marker of endothelial dysfunction and vascular damage. Discussion The presented protocol is to our knowledge the first to prospectively and with a multimodal approach, study serological and image biomarkers off early cardiac damage due to radiotherapy. With a practical clinical approach we will seek early changes that could potentially be in the future be linked to clinical mayor events with consequences for cancer survivors.

P1572Cardiovascular and inflammatory biomarkers in cancer patients and their impact on mortality

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L C Lueck ◽  
A Lena ◽  
S Hadzibegovic ◽  
P Weinlaender ◽  
A Letsch ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Prognostic Markers ◽  
Troponin T ◽  
Prognostic Impact ◽  
Healthy Controls ◽  
Male Body ◽  
Blood Biomarkers ◽  
Inflammatory Biomarker ◽  
Specificity And Sensitivity ◽  
Cv Disease

Abstract Background Cardiovascular (CV) blood biomarkers are considered prognostic markers of CV dysfunction during anti-cancer treatment. It is largely unknown, whether they are also prognostic markers for mortality. Purpose To investigate the prognostic impact of CV and inflammatory biomarker levels in cancer patients without significant CV disease at baseline on all-cause mortality. Methods We enrolled 138 unselected cancer patients without significant CV disease from November 2017 until December 2018 (age 63±14yrs, 45%male, body mass index (BMI) 25.5±7.7kg/m2) and 25 healthy controls (age 57±10yrs, 36% male, BMI 25.1±3.4kg/m2). The cancer group consisted of 85 lymphoma (62%), 25 breast cancer (18%), 10 colorectal cancer (7%), 11 non-small cell lung cancer (8%) and 7 other types of cancer (5%) patients. All cancer stages were represented (25% I/II, 76% III/IV). For biomarker analyses, blood samples were taken from an antecubital vein. Results N-terminal pro brain natriuretic peptide (NT-proBNP), high-sensitive Troponin T (hsTnT) and C-reactive protein (CRP) were significantly increased in cancer patients vs. healthy controls (90 ng/L [85–94] vs. 40 ng/L [35–45], p<0.0001; 89 ng/L [IQR 85–93] vs. 44 ng/L [39–48], p<0.0001; 84.3 mg/L [78.8–89.7] vs. 27.9 mg/L [22.5–33.4], p<0.0001). 29 cancer patients (21%) died during a mean follow-up time of 172 days (range 1–405) (6-month mortality 23% [95% CI 15–32]). In univariable Cox analyses all biomarkers predicted survival: NT-proBNP (per 100ng/L, HR 1.049 [1.013–1.085], p=0.0082), hsTnT (per 1ng/L, HR 1.017 [95% CI 1.006–1.029], p=0.0017) and CRP (per 1mg/L, HR 1.019 [1.009–1.030], p<0.0001). Including the two CV biomarkers and the inflammatory biomarker, cancer entity, cancer stage and other clinical variables in multivariable Cox analysis, all three biomarkers remained significant prognostic markers of mortality (NT-proBNP per 100ng/L, HR 1.044 [1.007–1.082], p=0.021; hsTnT per 1ng/L, HR 1.017 [1.005–1.030], p=0.0067; CRP per 1ng/L, HR 1.017 [1.005–1.029], p=0.0047). To predict survival, the best cut-offs for the highest product of specificity and sensitivity were 260ng/L for NT-proBNP, 12ng/L for hsTnT and 9mg/L for CRP. Conclusion In cancer patients without significant CV disease, plasma levels of the CV biomarkers NT-proBNP, hsTnT and the inflammatory biomarker CRP are elevated compared to healthy controls. All three blood biomarkers are independent prognostic markers of short-term mortality.

TUSARC: Prognostic Value of High-Sensitivity Cardiac Troponin T Assay in Asymptomatic Patients with High Cardiovascular Risk

2019 ◽  
Vol 132 (5) ◽  
pp. 631-638
Author(s):  
Diego Martín Raymondi ◽  
Héctor Garcia ◽  
Isabel Álvarez ◽  
Luis Hernández ◽  
Jorge Palazuelos Molinero ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
High Cardiovascular Risk ◽  
Asymptomatic Patients

scholarly journals Variability of high-sensitivity cardiac troponin T and I in asymptomatic patients receiving hemodialysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wanwarang Wongcharoen ◽  
Teetad Chombandit ◽  
Arintaya Phrommintikul ◽  
Kajohnsak Noppakun
Keyword(s):  
Cardiac Troponin ◽  
Observational Studies ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Asymptomatic Patients ◽  
Before And After ◽  
Suspected Acute Myocardial Infarction ◽  
Ctni Level ◽  
Regular Hemodialysis

AbstractVariation of high-sensitivity cardiac troponin I and T (hs-cTn) during hemodialysis has been observed. Observational studies demonstrated the increased incidence of adverse cardiovascular events after long compared to short interdialytic intervals. Therefore, we aimed to compare variation of hs-cTnI and hs-cTnT before and after hemodialysis and between short and long interdialytic intervals. We enrolled 200 asymptomatic patients receiving regular hemodialysis. The hs-cTnI and hs-cTnT levels were measured before and after hemodialysis on the day after short and long interdialytic intervals. Mean age was 62.3 ± 14.8 years (Male 55.5%). Prevalence of increased hs-cTnI and hs-cTnT was 34.5% and 99.0%, respectively. The median ± interquartile range of hs-cTnT increased significantly after hemodialysis during short and long interdialytic intervals. However, hs-cTnI level did not increase after hemodialysis during short and long intervals. We found that levels of hs-cTnI and T did not differ between short interdialytic and long interdialytic intervals. We demonstrated higher prevalence of elevated hs-cTnT in patients with regular hemodialysis compared to hs-cTnI. The rise of hs-cTnT was observed immediately after hemodialysis but no significant change of hs-cTnI was noted. Accordingly, hs-cTnI may be preferable as a diagnostic marker in patients with suspected acute myocardial infarction than hs-cTnT.

scholarly journals High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study

2021 ◽  
Author(s):  
Daniel Finke ◽  
Sebastian W. Romann ◽  
Markus B. Heckmann ◽  
Hauke Hund ◽  
Nina Bougatf ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Patients ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Single Centre ◽  
All Cause Mortality

scholarly journals Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage

2020 ◽  
pp. jech-2020-213885 ◽  
Author(s):  
Olena lakunchykova ◽  
Maria Averina ◽  
Tom Wilsgaard ◽  
Hugh Watkins ◽  
Sofia Malyutina ◽  
...  
Keyword(s):  
Troponin T ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Population Based ◽  
Cardiac Damage ◽  
Cross Sectional ◽  
Reactive Protein ◽  
The Difference ◽  
Cvd Mortality

BackgroundRussia has one of the highest rates of mortality from cardiovascular disease (CVD). At age 35–69 years, they are eight times higher than in neighbouring Norway. Comparing profiles of blood-based CVD biomarkers between these two populations can help identify reasons for this substantial difference in risk.MethodsWe compared age-standardised mean levels of CVD biomarkers for men and women aged 40–69 years measured in two cross-sectional population-based studies: Know Your Heart (KYH) (Russia, 2015–2018; n=4046) and the seventh wave of the Tromsø Study (Tromsø 7) (Norway, 2015–2018; n=17 646). A laboratory calibration study was performed to account for inter-laboratory differences.ResultsLevels of total, low-density lipoprotein-, high-density lipoprotein-cholesterol and triglycerides were comparable in KYH and Tromsø 7 studies. N-terminal pro-b-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity C-reactive protein (hsCRP) were higher in KYH compared with Tromsø 7 (NT-proBNP was higher by 54.1% (95% CI 41.5% to 67.8%) in men and by 30.8% (95% CI 22.9% to 39.2%) in women; hs-cTnT—by 42.4% (95% CI 36.1% to 49.0%) in men and by 68.1% (95% CI 62.4% to 73.9%) in women; hsCRP—by 33.3% (95% CI 26.1% to 40.8%) in men and by 35.6% (95% CI 29.0% to 42.6%) in women). Exclusion of participants with pre-existing coronary heart disease (279 men and 282 women) had no substantive effect.ConclusionsDifferences in cholesterol fractions cannot explain the difference in CVD mortality rate between Russia and Norway. A non-ischemic pathway to the cardiac damage reflected by raised NT-proBNP and hs-cTnT is likely to contribute to high CVD mortality in Russia.

scholarly journals The combination of high-sensitivity cardiac troponin T (hs-cTnT) at presentation and changes in N-terminal natriuretic peptide type B (NT-proBNP) after chemotherapy best predicts survival in AL amyloidosis

Blood ◽  
2010 ◽  
Vol 116 (18) ◽  
pp. 3426-3430 ◽  
Author(s):  
Giovanni Palladini ◽  
Alessandra Barassi ◽  
Catherine Klersy ◽  
Rosana Pacciolla ◽  
Paolo Milani ◽  
...  
Keyword(s):  
Treatment Response ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Al Amyloidosis ◽  
Type B ◽  
Cardiac Damage

AbstractIn light-chain (AL) amyloidosis, prognosis is dictated by cardiac dysfunction. N-terminal natriuretic peptide type B (NT-proBNP) and cardiac troponins (cTn) are used to assess the severity of cardiac damage. We evaluated the prognostic relevance of a high-sensitivity (hs) cTnT assay, NT-proBNP, and cardiac troponin I in 171 consecutive patients with AL amyloidosis at presentation and 6 months after treatment. Response and progression of NT-proBNP were defined as more than 30% and more than 300 ng/L changes. All 3 markers predicted survival, but the best multivariable model included hs-cTnT. The hs-cTnT prognostic cutoff was 77 ng/L (median survival 10.6 months for patients with hs-cTnT above the cutoff). After treatment, response and progression of NT-proBNP and a more than 75% increase of hs-cTnT were independent prognostic determinant. In AL amyloidosis, hs-cTnT is the best baseline prognostic marker. Therapy should be aimed at preventing progression of cardiac biomarkers, whereas NT-proBNP response confers an additional survival benefit.

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