Integración de marcadores humorales, ecocardiograma Doppler convencional y strain bidimensional sistólico en la detección de toxicidad miocárdica secundaria a la quimioterapia;
Serum Markers, Conventional Doppler Echocardiography and Two-dimensional Systolic Strain in the Diagnosis of Chemotherapy-Induced Myocardial Toxicity

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Background Left ventricular dysfunction is a serious complication of antineoplastic treatment with unfavorable impact in future clinical outcome. Early diagnosis of cardiotoxicity in patients receiving chemotherapy might be useful to define a strategy for the prevention of ventricular function impairment. Objective The aim of this study was to analyze the usefulness of serum markers (troponin T (TnT), BNP and NT-proBNP) and two-dimensional systolic longitudinal (LS) and radial (RS) strain to detect ventricular systolic dysfunction in patients treated with cardiotoxic chemotherapy. Methods Thirty six patients (average age (±SD) 47±16 years, 42% men), with neoplastic disease with normal myocardial mass and left ventricular ejection fraction (LVEF) ≥55% receiving chemotherapy treatment, were prospectively included. Assessment of serum markers and echocardiography were performed before chemotherapy and at 2, 3, 4 and 6 months after onset of cancer treatment. The 6-month cardiotoxicity endpoint (EP) was defined as reduced LVEF according to international consensus. Results Seven patients reached the EP (19.4%). Endpoint predictors were: NT-proBNP at 4 months (positive EP (G1): 152 ±42 pg/ml vs. negative EP (G2) 61±38 pg/ml, p< 0.001), BNP at 4 months (G1 41±12 pg/ml vs. G2 26±11 pg/ml, p< 0.01), twodimensional LS at 3 months (G1 16.3±2.4% vs. G2 19.6±2.02%, p< 0.01) and 4 months (G1 15.9±1.77% vs. G2 19.9±2.2%, p< 0.001), and two-dimensional RS at 4 months (G1 46.4±2.4% vs. G2 52±3.4%, p< 0.001). Conclusions Natriuretic peptides and two-dimensional systolic LS and RS were useful to predict mild ventricular systolic dysfunction in chemotherapy-treated patients.