Cardiac troponin T for early detection of cardiotoxicity in breast cancer patients treated with epirubicin
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Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
De Gruyter Poland Sp Zoo
Access Rights
info:eu-repo/semantics/closedAccess
Abstract
The aim of the study was to investigate the role of cTnT for the prediction of long term cardiac dysfunction after epirubicin-containing adjuvant chemotherapy for breast cancer. The study group comprised of 45 patients (all female; mean age 48 +/- 8 years), treated with epirubicin-containing adjuvant chemotherapy for stage 2 and stage 3 breast cancer. Patients received either 4 cycles of cyclophosphamide plus epirubicin (90 mg/m(2)) (n=23; stage 2 breast cancer) or 6 cycles of cyclophosphamide plus epirubicin (75 mg/m(2)) plus fluorouracil (n=18; stage 3 breast cancer). Venous blood samples were drawn, before and 72 hours after, every cycle of chemotherapy for the measurement of cTnT. Cardiac assessment was carried out at baseline and 1 year after chemotherapy by clinical evaluation, electrocardiography, radio-nuclide ventriculography (RNV) and transthoracic echocardiography. All patients remained free of clinical heart failure during the study period. In 26 patients (63%), cTnT was elevated after chemotherapy. Mean left ventricular ejection fraction, assessed by RNV at baseline and one year after chemotherapy, were 61 +/- 8% and 56 +/- 7% (p < 0.0001). The sensitivity and specifity of cTnT for the detection of left ventricular systolic dysfunction at one year were 69% and 39% respectively. Echocardiographic examinations at baseline and one year after chemotherapy revealed a significant decrease in E/A ratio from 1.15 +/- 0.3 to 0.9 +/- 0.2 in cTnT positive patients, suggesting diastolic dysfunction. In conclusion, elevated serum cTnT levels after epirubicin-containing adjuvant chemotherapy for stage 2 and stage 3 breast cancer, predict future cardiac dysfunction with moderate sensitivity and poor specificity.
Description
Keywords
Breast cancer, Chemotherapy, Epirubicin, Cardiotoxicity, cTnT, Anthracycline-Induced Cardiotoxicity, Adjuvant Chemotherapy, Diastolic Function, Childhood-Cancer, Leukemia, Survivors
Journal or Series
Central European Journal of Medicine
WoS Q Value
Q4
Scopus Q Value
N/A
Volume
4
Issue
3
