Key result
Adding GLS change >10% to Hs-Troponin and TNNI3K expression yielded 100% sensitivity and 95.5% specificity for early detection of anthracycline-induced cardiotoxicity.
Why the study?
Early identification of chemotherapy cardiotoxicity is crucial, and gene expression is considered a promising tool.
Does combining GLS, Hs-troponin, and TNNI3K gene expression improve early detection of cardiotoxicity in female breast cancer patients on anthracycline chemotherapy?
Observational (n=50)
Does combining GLS, Hs-troponin, and TNNI3K gene expression improve early detection of cardiotoxicity in female breast cancer patients on anthracycline chemotherapy?
A multimarker approach combining global longitudinal strain, Hs-troponin, and TNNI3K gene expression provides excellent diagnostic accuracy for the early detection of anthracycline-induced cardiotoxicity.
Answers are grounded in this paper and cite their sources.
Speckle tracking, Hs-troponin, and TNNI3K/RyR2 expression may aid early cardiotoxicity detection; leaves open prospective validation before practice change.
BACKGROUND: Early identification of cardiotoxicity of chemotherapy is crucial. Gene expression is considered a promising tool. AIM: To validate the new speckle tracking values, high-sensitive (Hs) troponin and expression of TNNI3K and RyR2 genes for early detection of cardiotoxicity. METHODS: Fifty patients with cancer breast on Anthracycline chemotherapy were subjected to speckle tracking echocardiography and Hs troponin measurement. Relative expression of TNNI3K and RyR2 genes were determined by RT-PCR. RESULTS: Fifty female patients with age (43.89 ± 6.4) were included. Fourteen patients (28%) developed cardiotoxicity, diagnosed by decrease GLS > 15%. Compared to GLS, Hs-Troponin has sensitivity 73%, specificity 100%, PPV 78.5% and NPV 100%. Cutoff point of GLS > 10% had sensitivity 95%, specificity 78%, PPV 81% and NPV 84%. Using a cutoff of 24% change in TNNI3K Expression; sensitivity 100%, specificity 74%, PPV 79.5% and NPV 100%. Using a cutoff of 25% in RYR-2 expression; sensitivity 67% and specificity 59% with less PPV and NPV (62% and 64%). Adding GLS change >10% to Hs troponin and TNNI3K expression resulted in highest sensitivity (100%) and specificity (95.5%) with 96% PPV and 100% NPV. CONCLUSION: Cutoff point of GLS > 10%, Hs-Troponin and TNNI3K gene expression are reliable test for early detection of cardiotoxicity. TRIAL REGISTRATION NUMBER (IRB): 042024100222.
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Mahmoud et al. (2025) conducted an observational in Breast cancer on Anthracycline chemotherapy (n=50). GLS change >10%, Hs-Troponin, and TNNI3K/RyR2 gene expression vs. GLS decrease > 15% (reference standard) was evaluated on Early detection of cardiotoxicity. Adding GLS change >10% to Hs-Troponin and TNNI3K expression yielded 100% sensitivity and 95.5% specificity for early detection of anthracycline-induced cardiotoxicity.
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