Serum biomarkers are an important tool in the baseline risk assessment and diagnosis of cardiovascular disease in cancer patients receiving cardiotoxic cancer treatments. Increases in cardiac biomarkers including cardiac troponin and natriuretic peptides can be used to guide initiation of cardioprotective treatments for cancer patients during treatment and to monitor the response to cardioprotective treatments, and they also offer prognostic value. This position statement examines the role of cardiac biomarkers in the management of cancer patients. The Cardio-Oncology Study Group of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in collaboration with the Cardio-Oncology Council of the ESC have evaluated the current evidence for the role of cardiovascular biomarkers in cancer patients before, during and after cardiotoxic cancer therapies. The characteristics of the main two biomarkers troponin and natriuretic peptides are discussed, the link to the mechanisms of cardiovascular toxicity, and the evidence for their clinical use in surveillance during and after anthracycline chemotherapy, trastuzumab and HER2-targeted therapies, vascular endothelial growth factor inhibitors, proteasome inhibitors, immune checkpoint inhibitors, cyclophosphamide and radiotherapy. Novel surveillance clinical pathways integrating cardiac biomarkers for cancer patients receiving anthracycline chemotherapy or trastuzumab biomarkers are presented and future direction in cardio-oncology biomarker research is discussed.

• MeSH
• antitumorózní látky * aplikace a dávkování   škodlivé účinky   MeSH
• kardiotonika aplikace a dávkování   MeSH
• kardiotoxicita * krev   diagnóza   etiologie   MeSH
• lidé MeSH
• nádorové biomarkery krev   MeSH
• nádory * krev   farmakoterapie   MeSH
• srdeční selhání * krev   chemicky indukované   diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

• MeSH
• analýza rozptylu MeSH
• antibiotika antitumorózní * toxicita   MeSH
• antracykliny terapeutické užití   MeSH
• biologické markery krev   metabolismus   MeSH
• daunomycin toxicita   MeSH
• echokardiografie MeSH
• funkční vyšetření srdce MeSH
• kardiomyopatie * chemicky indukované   krev   MeSH
• kardiotoxicita krev   MeSH
• králíci MeSH
• modely u zvířat MeSH
• plocha pod křivkou MeSH
• troponin T * krev   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH

BACKGROUND: Cardiac troponins (cTns) seem to be more sensitive for the detection of anthracycline cardiotoxicity than the currently recommended method of monitoring LV systolic function. However, the optimal timing of blood sampling remains unknown. Hence, the aims of the present study were to determine the precise diagnostic window for cTns during the development of chronic anthracycline cardiotoxicity and to evaluate their predictive value. METHODS: Cardiotoxicity was induced in rabbits with daunorubicin (3mg/kg, weekly, for 8 weeks). Blood samples were collected 2-168 h after the 1st, 5th and 8th drug administrations, and concentrations of cTns were determined using highly sensitive assays: hs cTnT (Roche) and hs cTnI (Abbott). RESULTS: The plasma levels of cTns progressively increased with the rising number of chemotherapy cycles. While only a mild non-significant increase in both cTn levels occurred after the first daunorubicin dose, a significant rise was observed after the 5th and 8th administrations. Two hours after these administrations, a significant increase occurred with a peak between 4-6h and a decline until 24h. Discrete cTn release continued even after cessation of the therapy. While greater variability of cTn levels was observed around the peak concentrations, the values did not correspond well with the severity of LV systolic dysfunction. Unlike AMI in cardiotoxicity, cTn elevations may be better associated with cumulative dose and concentrations at steady state than cmax. CONCLUSIONS: To the best of our knowledge, this is the first study to precisely describe the diagnostic window and predictive value of cTns in anthracycline cardiotoxicity.

• MeSH
• antibiotika antitumorózní toxicita   MeSH
• antracykliny toxicita   MeSH
• biologické markery krev   metabolismus   MeSH
• daunomycin toxicita   MeSH
• echokardiografie MeSH
• kardiomyopatie krev   chemicky indukované   MeSH
• kardiotoxicita krev   ultrasonografie   MeSH
• králíci MeSH
• modely nemocí na zvířatech MeSH
• prediktivní hodnota testů MeSH
• regresní analýza MeSH
• srdce účinky léků   fyziologie   MeSH
• systola účinky léků   fyziologie   MeSH
• troponin I krev   MeSH
• troponin T krev   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Catecholamines are endogenous amines that participate in the maintenance of cardiovascular system homeostasis. However, excessive release or exogenous administration of catecholamines is cardiotoxic. The synthetic catecholamine, isoprenaline (isoproterenol, ISO), with non-selective β-agonistic activity has been used as a viable model of acute myocardial toxicity for many years. Since the pathophysiology of ISO-cardiotoxicity is complex, the aim of this study was to elucidate the effect of oral quercetin pretreatment on myocardial ISO toxicity. Wistar-Han rats were randomly divided into four groups: solvent or quercetin administered orally by gavage in a dose of 10 mg kg(-1) daily for 7 days were followed by s.c. water for injection or ISO in a dose of 100 mg kg(-1). Haemodynamic, ECG and biochemical parameters were measured; effects on blood vessels and myocardial histology were assessed, and accompanying pharmacokinetic analysis was performed. Quercetin was unable to protect the cardiovascular system against acute ISO cardiotoxicity (stroke volume decrease, cardiac troponin T release, QRS-T junction elevation and histological impairment). The sole positive effect of quercetin on catecholamine-induced cardiotoxicity was the normalization of increased left ventricular end-diastolic pressure caused by ISO. Quercetin did not reverse the increased responsiveness of rat aorta to vasoconstriction in ISO-treated animals, but it decreased the same parameter in the control animals. Accompanying pharmacokinetic analysis showed absorption of quercetin and its metabolite 3-hydroxyphenylacetic acid formed by bacterial microflora. In conclusion, a daily oral dose of 10 mg kg(-1) of quercetin for 7 days did not ameliorate acute ISO-cardiovascular toxicity in rats despite minor positive cardiovascular effects.

• MeSH
• aorta thoracica účinky léků   fyziologie   MeSH
• aplikace orální MeSH
• hemodynamika MeSH
• isoprenalin MeSH
• kardiotoxicita krev   farmakoterapie   patologie   patofyziologie   MeSH
• krysa rodu rattus MeSH
• myokard patologie   MeSH
• quercetin krev   farmakokinetika   terapeutické užití   MeSH
• troponin T krev   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Klíčová slova
• diagnostické okno, srdeční troponiny, kardioprotekce,
• MeSH
• antracykliny škodlivé účinky   MeSH
• biologické markery krev   MeSH
• kardiomyocyty účinky léků   MeSH
• kardiomyopatie chemicky indukované   prevence a kontrola   MeSH
• kardiotonika škodlivé účinky   MeSH
• kardiotoxicita * etiologie   krev   MeSH
• katecholaminy škodlivé účinky   MeSH
• lidé MeSH
• troponin I * fyziologie   krev   MeSH
• troponin T * fyziologie   krev   MeSH
• Check Tag
• lidé MeSH

• MeSH
• antitumorózní látky aplikace a dávkování   škodlivé účinky   MeSH
• biologické markery krev   MeSH
• hematologické nádory farmakoterapie   MeSH
• kardiotoxicita * krev   MeSH
• leukemie farmakoterapie   MeSH
• lidé MeSH
• transplantace hematopoetických kmenových buněk metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

• MeSH
• antracykliny aplikace a dávkování   škodlivé účinky   MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• kardiotoxicita krev   MeSH
• leukemie farmakoterapie   MeSH
• lidé MeSH
• troponin krev   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH