Key result
Chemotherapy administration was associated with a significant increase in mean BNP levels (from 40.4 to 44.6 ng/L, p=0.02) and asymptomatic EKG changes, suggesting the feasibility of these tools for early detection of sub-clinical cardio-toxicity.
Why the study?
Does the use of 12-lead telemetry, 7-day EKG monitoring, BNP, and IMA detect sub-clinical cardiotoxicity in patients undergoing chemotherapy?
Observational (n=66)
No
Does the use of 12-lead telemetry, 7-day EKG monitoring, BNP, and IMA detect sub-clinical cardiotoxicity in patients undergoing chemotherapy?
Advanced diagnostic monitoring using telemetry, prolonged EKG, and biomarkers is feasible and can detect sub-clinical cardiac changes during chemotherapy administration.
Answers are grounded in this paper and cite their sources.
Supports BNP/EKG monitoring for subclinical cardiotoxicity detection during chemotherapy; hypothesis-generating and requires prospective validation before practice change.
Chemotherapy induced cardio-toxicity is a well known side effect of anticancer treatments, moreover the 70% of all tumors involve patients over 65 years-old, frequently with cardiac co- morbidity. We evaluated the feasibility of the application during chemotherapy administration of some of the most recent diagnostic techniques as 12-diagnostic leads telemetry, 7 days EKG monitoring device (R-Test Evolution 3R), blood level dosage of Brain Natriuretic Peptide (BNP) and Ischemia Modified Albumin (IMA). Some sub-clinical changes in the investigated parameters were found in patients undergoing chemotherapy, mostly containing fluorouracil, as shown in the following paper. Far from suggesting a widespread use of these methods during chemotherapy administration, we think that some more tools are needed to prevent cardiac toxicity in high-risk patients and some of what we studied may deserve further valuation in chemotherapy clinical trials.
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Zustovich et al. (2010) conducted an observational in Solid tumors undergoing chemotherapy (n=66). Chemotherapy (fluorouracil, gemcitabine) vs. Baseline (pre-chemotherapy) was evaluated on Mean Brain Natriuretic Peptide (BNP) levels before and 5 hours after chemotherapy in patients with normal basal BNP (< 100 ng/L) (p=0.02). Chemotherapy administration was associated with a significant increase in mean BNP levels (from 40.4 to 44.6 ng/L, p=0.02) and asymptomatic EKG changes, suggesting the feasibility of these tools for early detection of sub-clinical cardio-toxicity.
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