Chemotherapy-induced cardiotoxicity

Abstract EN

It is now evident that the mortality from different malignancies has much decreased due to the well-established therapeutic benefits of either old or new chemotherapeutic agents.

The clinical success of chemotherapy is much hampered by the development of many side effects mainly cardiotoxicity which leads to the occurrence of cardiomyopathy and subsequently congestive heart failure.

The current approaches for the detection of cardiotoxicity related to chemotherapy are lacking the sensitivity and specificity for the prediction of the development of cardiomyopathy hence came the need for new modalities that allow for the detection of cardiac damage before overt clinical cardiovascular consensuses occur.

Cardiac troponins have shown from clinical trial high diagnostic accuracy for the early detection of cardiac damage after chemotherapy as early as 3 months before the clinical onset of cardiomyopathy.

It was also found that the increase in their concentrations is directly correlated with disease severity and may predict the development of major cardiac events.

On the other side, the presence of negative troponin makes the patient at a very low risk of cardiotoxicity with a negative predictive value of 99 %.

The other marker is cardiac natriuretic peptides which still needs evidence through clinical trials to establish its role in the diagnosis and prognosis of chemotherapy-induced cardiomyopathy.