Study of some clinical parameters and cardiac biomarkers for early diagnosis of anthracycline-induced cardiotoxicity in child - 25/12/18
Résumé |
Introduction |
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.
Objectives |
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.
Methods |
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.
Results |
Changes in the parameters investigated: (1) Increased QT/QTc intervals 73% of cases, particularly in patients with a combined anthracycline dose>250mg/m2 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 89ng/mL to 240ng/mL Biological changes were correlated with the presence of clinical signs, echo-induced cardiotoxicity changes and increased QT/QTc interval dispersion.
Conclusions |
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.
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Vol 11 - N° 1
P. 34 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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