Study of some clinical parameters and cardiac biomarkers for early diagnosis of anthracycline-induced cardiotoxicity in child

Abstract

Cardiomyopathy induced by the anthracycline cardiotoxicity aggravates the prognosis of the underlying disease and requires an early diagnosis even before the clinical manifestations of myocardial infarction. Establishing the utility of QT and QTc interval dispersion research and cardiac biomarker values, natriuretic peptide B (BNP), for the early detection of anthracycline-induced cardiotoxicity in children with haematological malignancies. Patients - 46 children (aged 2 months to 18 years) treated with anthracyclines for haematological malignancies (leukemias, malignant lymphomas). Control group: 20 apparently healthy children without a history of cardiovascular disease. Patients and the control group were evaluated by clinical examination, 12-channel ECG (3 consecutive QT/QTc interval dispersion), echocardiography (Echo), BNP plasma concentrations. Changes in the parameters investigated: (1) Increased QT/QTc intervals 73% of cases, particularly in patients with a combined anthracycline dose > 250 mg/m 2 and in patients with Echo modifications induced by anthracycline cardiotoxicity, even just a diastolic dysfunction of VS. QT interval average: 80 milliseconds in patients/40 milliseconds in controls; QTc median dispersion: 87,103 milliseconds in patients vs. 55.47 milliseconds in controls; (2) Elevated BNP in 45.7% of patients: mean baseline 89 ng/mL to 240 ng/mL Biological changes were correlated with the presence of clinical signs, echo-induced cardiotoxicity changes and increased QT/QTc interval dispersion. Elevated BNP and QT/QTc intervals in children treated with anthracyclines correlate positively with the occurrence of severe cardiotoxicity manifestations, represent a useful indicator for cardiotoxicity. Changes in these parameters occurred early in cardiotoxicity-induced echo changes and systematic monitoring of these parameters during and after cytostatic treatment is required.