Ruolo del brain natriuretic peptide (BNP) nella gestione della cardiotossicità da farmaci antiblastici

Translated title of the contribution: The rôle of brain natriuretic peptide (BNP) in the management of chemotherapy-induced cardiotoxicity

Virginio Filipazzi, Valentina Gambi, Cinzia Fasola, Anna Gambaro, Nicoletta Tosca, Laura Dalla Vecchia, Elisabetta Schiavello, Tarcisio Vago, Sabrina Ferrario, Carolina Sarnataro, Luigi Isabella, Stefania Zambelli, Maria Teresa Cattaneo, Elena Piazza

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The monitoring of chemotherapy-induced cardiotoxicity is a problem faced daily in oncology. The Brain Natriuretic Peptide (BNP) is increasingly reported in the literature as a sensitive marker of myocardial damage, predictive of the evolution towards circulatory failure in several cardiac pathologies. Methods. The N-terminal (NT) fragment of proBNP is the inactive fragment of the BNP, produced by human cardiomyocytes in an early stage of congestive heart failure; it has been evaluated by electrochemiluminescence (ECLIA) in 110 patients before and after treatment with potentially cardiotoxic chemotherapy schedules. In 31 subjects the relationship between marker levels and echocardiographic and EcoColor Doppler signs of cardiac dysfunction has also been evaluated. Patients with renal failure, arterial hypertension, ascites and diabetes were excluded. Results. The trend of NT-proBNP increases significantly in patients submitted to antitumour treatments containing 5-fluorouracil and anthracyclines: 13% of patients with normal marker values at the start of therapy reach values over cut-off level by the end of treatment. In patients submitted to echocardiographic and Color Doppler monitoring, a slight relationship has been observed between peptide increase and diastolic cardiac dysfunction, evaluated by the E/A ratio (ratio between early and late diastolic peak), and the DT (deceleration time of E wave). No subjects presented symptoms of heart failure. Conclusions. In our experience NT-proBNP increases significantly during potentially cardiotoxic therapies, such as anthracyclines and 5-fluorouracil, so emphasizing its possible rôle in the early identification of cardiac damage and, furthermore, as an additional method for the selection of patients at cardiac risk, to be submitted to subsequent periodic echocardiographic controls.

Translated title of the contributionThe rôle of brain natriuretic peptide (BNP) in the management of chemotherapy-induced cardiotoxicity
Original languageItalian
Pages (from-to)93-99
Number of pages7
JournalEuropean Journal of Oncology
Volume12
Issue number2
Publication statusPublished - Jun 2007

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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