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Boletín Médico del Hospital Infantil de México

2013, Number 2

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Bol Med Hosp Infant Mex 2013; 70 (2)

Timely diagnosis of myocardial damage in patients treated with anthracyclines: a challenge for the 21st century

Navarrete-Rodríguez EM, Zapata-Tarrés MM, Vera-Hermosillo H, Erdmenger-Orellana J, López-Martínez B, Becerra-Becerra R

Language: Spanish
References: 18
Page: 72-77
PDF size: 293.83 Kb.


ABSTRACT

Background. Currently used methods for assessment of myocardial damage in patients treated with anthracyclines are deficient in detecting mild myocardial damage. Troponin I is part of the protein contractile machinery in the myofibril and is used as a specific biomarker of myocardial damage. The aim of the study was to compare troponin I levels in patients with prior anthracycline use after a new cycle of chemotherapy.
Methods. We included patients aged from 9 to 18 years who were diagnosed with cancer and were being treated with anthracyclines at the Hospital Infantil de México Federico Gómez. We analyzed serum troponin I prior to and after the new cycle of chemotherapy and compared the results, always in a blinded manner.
Results. The mean cumulative dose of anthracyclines in the study population was 234 mg/m2 SC for daunorubicin and 269 mg/m2 SC for doxorubicin. There was no significant systolic dysfunction according to echocardiography. Impaired mobility of left ventricular walls was observed using SPECT-CT. There was no evidence of increased levels of troponin I in serum after application of a new dose of anthracyclines.
Conclusions. Extensive research with mixed results has been carried out in regard to biomarkers that aid in the early diagnosis of cardiomyopathy secondary to anthracycline. Taking into account the kinetics of troponin I in myocardial damage is a critical step for evaluation. Using this premise, we did not find an increase of this biomarker in blood after myocardial damage secondary to administration of anthracyclines.


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