Brain natriuretic peptide as a cardiac marker of transient radiotherapy-related damage in left-sided breast cancer patients: A prospective study

Autor: Cynthia Aristei, M.E. Latini, E. Perrucci, I. Sabalich, M. Marcantonini, Mario Luca Fravolini, Isabella Palumbo, L. Falcinelli, Elmo Mannarino, Barbara Palumbo, Cristina Tranfaglia, Giuseppe Schillaci
Rok vydání: 2015
Předmět:
Adult
medicine.medical_specialty
medicine.drug_class
Cardiac marker
Ventricular Function
Left
030218 nuclear medicine & medical imaging
03 medical and health sciences
Dosimetric parameters
Electrocardiography
0302 clinical medicine
Internal medicine
Natriuretic Peptide
Brain
Natriuretic peptide
Unilateral Breast Neoplasms
Medicine
Humans
cardiovascular diseases
Myocardial infarction
Prospective Studies
Prospective cohort study
Aged
Aged
80 and over
Ejection fraction
medicine.diagnostic_test
Radiotherapy
business.industry
Heart
Stroke Volume
General Medicine
Stroke volume
Middle Aged
Brain natriuretic peptide
medicine.disease
Cardiac toxicity
Left breast cancer
Cardiotoxicity
030220 oncology & carcinogenesis
cardiovascular system
Cardiology
Surgery
Female
Radiotherapy
Adjuvant
business
Biomarkers
circulatory and respiratory physiology
Follow-Up Studies
Zdroj: Breast (Edinburgh, Scotland). 25
ISSN: 1532-3080
Popis: Our study evaluated brain natriuretic peptide (BNP) changes over time after adjuvant radiotherapy (RT) in women with left-sided breast cancer investigating its correlation with heart dosimetric parameters.Forty-three patients underwent clinical cardiac examination, electrocardiogram (ECG), echocardiography and BNP measurement before RT (T0) and 1 (T1), 6 (T6) and 12 months (T12) after. After T12 cardiac assessment was performed annually in each patient. Mean values and standard deviation (SD) of BNP, left ventricular ejection fraction (LVEF), V20, V25, V30, V45 and mean dose were calculated. Normalized BNP (BNPn) was calculated as follows: BNPnT1 = BNPT1/BNPT0, BNPnT6 = BNPT6/BNPT0, BNPnT12 = BNPT12/BNPT0. Absolute BNP and BNPn values were used for data analysis.Median follow-up from the end of RT to the last check-up was 87 months (range 37-120 months). Minimum follow-up was 74 months except for two patients, who died at respectively 37 and 47 months after RT. In all patients LVEF did not change significantly (p = 0.22) after RT. BNP increased significantly (p 0.001), particularly 1 and 6 months after RT. It slightly decreased after 12 months. BNP did not correlate with V20, V25, V30, V45, mean dose and MHD. All BNPn correlated significantly (p 0.05) with V20, V25, V30, V45, mean dose and MHD. Four patients had a cardiac event; in the only subject who developed myocardial infarction, V20, V25, V30 and V45 were the highest and BNP increased from T1 and persisted high even at T12.Our results confirm that BNP could be a useful minimally invasive marker of early RT related cardiac impairment.
Databáze: OpenAIRE
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