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Cardiac Complications of Chemotherapy: Role of Biomarkers

  • Cardio-oncology (S Francis, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

Both conventional and novel antineoplastic drugs may cause damage to the heart, ultimately affecting patients’ survival and quality of life. In fact, the most frequent and typical clinical manifestation of cardiotoxicity, asymptomatic or symptomatic left ventricular dysfunction, may be induced not only by conventional cancer therapy, like anthracyclines, but also by new antitumoral targeted therapy such as trastuzumab. At present, left ventricular ejection fraction assessment represents the main standard practice for cardiac monitoring during cancer therapy, but it detects myocardial damage only when a functional impairment has already occurred, not allowing for early preventive strategies. In the last decade, a newer approach based on the measurement of cardiospecific biomarkers has been proposed, proving to have higher prognostic value than imaging modalities. In particular, cardiac troponin elevation during chemotherapy allows us to identify patients who are more prone to develop myocardial dysfunction and cardiac events during follow up. In these patients, the use of an angiotensin-converting enzyme inhibitor, such as enalapril, has shown to be effective in improving clinical outcome, giving the chance for a cardioprotective strategy in a selected population.

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Abbreviations

CT:

chemotherapy

LVEF:

left ventricular ejection fraction

MUGA:

radionuclide multi-gated acquisition

NP:

natriuretic peptides

cTnI:

cardiac troponin I

cTnT:

cardiac troponin T

HF:

heart failure

AC:

anthracycline

LVD:

left ventricular dysfunction

HS:

highly sensitive

NT-proBNP:

N-terminal pro-brain natriuretic peptide

CMP:

cardiomyopathy

ACEI:

angiotensin-converting enzyme inhibitor

BB:

beta-blocker

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Conflict of Interest

Dr. Alessandro Colombo, Dr. Maria T. Sandri, Dr. Michela Salvatici, Dr. Carlo M. Cipolla, and Dr. Daniela Cardinale each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Cardiology Division, European Institute of Oncology, I.R.C.C.S., Via Ripamonti 435, 20141, Milan, Italy

    Alessandro Colombo MD & Carlo M. Cipolla MD

  2. Laboratory Medicine Division, European Institute of Oncology, I.R.C.C.S., Milan, Italy

    Maria T. Sandri MD

  3. Cardioncology Unit, European Institute of Oncology, I.R.C.C.S., Milan, Italy

    Michela Salvatici DSc & Daniela Cardinale MD, PhD, FESC

Authors
  1. Alessandro Colombo MD
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  2. Maria T. Sandri MD
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  3. Michela Salvatici DSc
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  4. Carlo M. Cipolla MD
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  5. Daniela Cardinale MD, PhD, FESC
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Correspondence to Alessandro Colombo MD.

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This article is part of the Topical Collection on Cardio-oncology

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Colombo, A., Sandri, M.T., Salvatici, M. et al. Cardiac Complications of Chemotherapy: Role of Biomarkers. Curr Treat Options Cardio Med 16, 313 (2014). https://doi.org/10.1007/s11936-014-0313-6

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