Use of cardiac markers as monitoring of doxorubixin induced cardiotoxicity in children with cancer

  • Dr Yupada Pongprot, Department of Pediatrics, Chiang Mai University,Thailand, 50200, Thailand
  • Dr Rekwan Sittiwangkul, Department of Pediatrics, Chiang Mai University,Thailand, 50200, Thailand
  • Dr Pattra Thanarattanakorn, Department of Pediatrics, Chiang Mai University,Thailand, 50200, Thailand
  • Dr Pimlak Charoenkwan, Department of Pediatrics, Chiang Mai University,Thailand, 50200, Thailand
  • Dr Suchaya Silvilairat, Department of Pediatrics, Chiang Mai University,Thailand, 50200, Thailand

    • Background: Anthracyclines chemotherapy are associated with increased risk of arrhymias, pericarditis and ventricular dysfunction. Echocardiography has been used as a screening test in children with cancer after anthracycline therapy.

    Objective: To evaluate NT-proBNP, cardiac troponin T and CKMB comparing with echocardiographically cardiac function in childhood cancer treated with doxorubicin.

    Method: We performed prospective study of systolic, diastolic function and tissue Doppler imaging by echocardiogram in children with cancer who received accumulative dose of doxorubicin between 50-350 mg/m2 . Blood level for NT-proBNP, cardiac troponin T and CK-MB were analyzed within 6 hours of cardiac study.

    Result: Of 22 patients 8(36%) had abnormally high mean NT-proBNP level of 389±71 pg/ml compared with 74.91±60 pg/ml in normal level group. As the drug dose increased, NT-proBNP level increased correlated significantly with decreased ejection fraction(EF) (r=-0.36, P=0.05) and decreased deceleration time (DT)(r=-0.37,P<0.05). In this study, tissue Doppler imaging could not early detect systolic and diastolic dysfunction. CKMB and cardiac troponin T were abnormal in only 3 and 2 patients respectively.

    Conclusion: NT-proBNP is a useful cardiac marker for monitoring of anthracycline cardiotoxicity due to its good correlation with systolic and diastolic function. CKMB and cardiac troponin T were suggested to be insensitive.