• Laila M Sherief, Ahmad G Kamal, E A Khalek, Naglaa M Kamal, Attia A A Soliman, and Asmaa M Esh.
• Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt.
• Hematology. 2012 May 1; 17 (3): 151-6.

BackgroundThe main strategy for minimizing anthracycline cardiotoxicity is early detection of high-risk patients.Aim Of The StudyTo investigate the role of cardiac biomarkers; cardiac troponin T (cTnT) and N-terminal probrain natriuretic peptide (NT-pro-BNP), and tissue Doppler imaging (TDI), as early predictors of chronic cardiotoxicity in survivors of acute leukemia.Patients And MethodsWe carried a retrospective study on 50 asymptomatic survivors of acute leukemia who received anthracycline in their treatment protocols. All patients underwent blood sampling to determine the levels of NT-pro-BNP and cTnT along with conventional echocardiography and TDI.ResultsNone had abnormal cTnT levels. About 20% had abnormal NT-pro-BNP levels. Diastolic dysfunction of the left ventricle was the most significant in conventional echocardiography. TDI was superior as it detected myocardial affection in 10% more than echo. TDI demonstrated global myocardial damage with significant aberrations in peak myocardial velocities and ratios.ConclusionsNT-pro-BNP can be used as a sensitive cardiac biomarker in monitoring of anthracycline-induced cardiotoxicity. Follow up is essential to validate the role of NT-pro-BNP as an early marker for late onset anthracycline-induced cardiotoxicity. Tissue Doppler is marvelous as it could detect early cardiac dysfunction even in those with normal study by conventional echocardiography.

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