What does this research mean for the field?

Elevated natriuretic peptides (BNP and NT-proBNP) and reduced two-dimensional longitudinal and radial strain at 3 to 4 months predict 6-month chemotherapy-induced ventricular systolic dysfunction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the efficacy of cardiac serum biomarkers and two-dimensional echocardiographic strain in detecting early chemotherapy-induced ventricular systolic dysfunction.

May 29, 2013

Serum Markers, Conventional Doppler Echocardiography and Two-dimensional Systolic Strain in the Diagnosis of Chemotherapy-Induced Myocardial Toxicity

Q: What are the key findings of this study?

Elevated NT-proBNP and BNP, along with reduced two-dimensional longitudinal and radial strain at 3 to 4 months, significantly predicted 6-month chemotherapy-induced ventricular systolic dysfunction.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Chemotherapy-induced myocardial toxicity (n=36). Intervention: Serum markers (TnT, BNP, NT-proBNP) and two-dimensional longitudinal and radial strain. Primary outcome: 6-month cardiotoxicity (reduced LVEF according to international consensus) (p=<0.001).

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Key result

Elevated NT-proBNP, BNP, and reduced 2D strain at 3-4 months predict 6-month chemotherapy-induced cardiotoxicity.

P<0.001
n=36

Why the study?

Do serum markers and two-dimensional strain echocardiography predict reduced LVEF in patients receiving cardiotoxic chemotherapy?

Population

36 patients with neoplastic disease, normal myocardial mass, and LVEF ≥55% receiving chemotherapy treatment…

Design

Cohort

Follow-up

6 months

Authors

SBSergio BarattaHospital Universitario Austral MMMaría Laura MarcheseAustral University JTJ TruccoHospital Universitario Austral

Discussion

Member takes

Implication

Strain imaging and markers may enable earlier cardiotoxicity detection; hypothesis-generating and should not yet change practice.

Key Points

To evaluate the efficacy of cardiac serum biomarkers and two-dimensional echocardiographic strain in detecting early chemotherapy-induced ventricular systolic dysfunction.
Prospective study of N=36 cancer patients (mean age 47±16 years, 42% male) with baseline left ventricular ejection fraction (LVEF) ≥55% receiving cardiotoxic chemotherapy.
Serum biomarkers (troponin T, BNP, NT-proBNP) and echocardiography (longitudinal and radial strain) were measured before chemotherapy and at 2, 3, 4, and 6 months post-treatment initiation.
The primary endpoint was cardiotoxicity defined as reduced LVEF at 6 months according to international consensus.
Seven patients reached the cardiotoxicity endpoint (19.4%).
Patients developing cardiotoxicity exhibited significantly higher 4-month NT-proBNP (152±42 vs. 61±38 pg/ml; p<0.001) and BNP (41±12 vs. 26±11 pg/ml; p<0.01) compared to those who did not.
Cardiotoxicity was preceded by lower longitudinal strain at 3 months (-16.3±2.4% vs. -19.6±2.02%; p<0.01) and 4 months (-15.9±1.77% vs. -19.9±2.2%; p<0.001), as well as lower radial strain at 4 months (46.4±2.4% vs. 52±3.4%; p<0.001).

Study Design

Type

Cohort (n=36)

Structured PICO

Do serum markers and two-dimensional strain echocardiography predict reduced LVEF in patients receiving cardiotoxic chemotherapy?

Population

36 patients (mean age 47 years, 58% female) with neoplastic disease and normal baseline LVEF receiving chemotherapy, followed prospectively for 6 months.

Exposure

Assessment of serum markers (troponin T, BNP, NT-proBNP) and two-dimensional longitudinal and radial strain echocardiography before and at 2, 3, 4, and 6 months after onset of chemotherapy.

Outcome

6-month cardiotoxicity endpoint defined as reduced LVEF according to international consensus.surrogate

Main Result

p-value: p=<0.001

Natriuretic peptides and two-dimensional longitudinal and radial strain are useful early predictors of chemotherapy-induced mild ventricular systolic dysfunction.

Cite This Study

Baratta et al. (2013) conducted a cohort in Chemotherapy-induced myocardial toxicity (n=36). Serum markers (TnT, BNP, NT-proBNP) and two-dimensional longitudinal and radial strain was evaluated on 6-month cardiotoxicity (reduced LVEF according to international consensus) (p=<0.001). Elevated NT-proBNP and BNP, along with reduced two-dimensional longitudinal and radial strain at 3 to 4 months, significantly predicted 6-month chemotherapy-induced ventricular systolic dysfunction.

synapsesocial.com/papers/6aa779f4d5e1e820a0050d98 https://doi.org/10.7775/ajc.81.2.2300

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Serum Markers, Conventional Doppler Echocardiography and Two-dimensional Systolic Strain in the Diagnosis of Chemotherapy-Induced Myocardial Toxicity

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Serum Markers, Conventional Doppler Echocardiography and Two-dimensional Systolic Strain in the Diagnosis of Chemotherapy-Induced Myocardial Toxicity

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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