Role of Cardiac Biomarkers in Cancer Patients
In patients with cancer—and especially some specific subtypes—the heart can be pathologically affected due to the direct action of the tumor or its secretion products or due to the toxicity of some oncological treatments. Cardiac biomarkers have been investigated as inexpensive and easily accessible...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/21/5426 |
| _version_ | 1797512703371116544 |
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| author | Gennaro Carmine Semeraro Carlo Maria Cipolla Daniela Maria Cardinale |
| author_facet | Gennaro Carmine Semeraro Carlo Maria Cipolla Daniela Maria Cardinale |
| author_sort | Gennaro Carmine Semeraro |
| collection | DOAJ |
| description | In patients with cancer—and especially some specific subtypes—the heart can be pathologically affected due to the direct action of the tumor or its secretion products or due to the toxicity of some oncological treatments. Cardiac biomarkers have been investigated as inexpensive and easily accessible tools for prediction, early diagnosis, monitoring, or prognosis of various forms of cancer-related cardiac diseases. However, their clinical usefulness was not always clearly demonstrated in every area of cardioncology. For the identification of anthracycline related cardiotoxicity in the very early stages troponins proved to be more efficient detectors than imaging methods. Nevertheless, the lack of a standardized dosage methodology and of cardiotoxicity specific thresholds, do not yet allow to outline the precise way to employ them in clinical routine and to incorporate them into appropriate diagnostic or managing algorithms. Cardiac biomarkers proved also effective in patients with primary cardiac amyloidosis, in which both troponins and natriuretic peptides were able to predict adverse outcome, and carcinoid heart disease, where a precise diagnostic cut-off for N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was identified to screen patients with valvular involvement. Likewise, NT-proBNP proved to be an excellent predictor of postoperative atrial fibrillation (POAF). On the contrary, evidence is still not sufficient to promote the routine use of cardiac biomarkers to early diagnose myocarditis due to immune check points inhibitors (ICIs), radiotherapy induced cardiotoxicity and cardiac complications related to androgenetic deprivation. In this review we present all the evidence gathered so far regarding the usefulness and limitations of these relatively inexpensive diagnostic tools in the field of cardio-oncology. |
| first_indexed | 2024-03-10T06:05:27Z |
| format | Article |
| id | doaj.art-490324f329744bee9111f56a5418de51 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T06:05:27Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-490324f329744bee9111f56a5418de512023-11-22T20:35:05ZengMDPI AGCancers2072-66942021-10-011321542610.3390/cancers13215426Role of Cardiac Biomarkers in Cancer PatientsGennaro Carmine Semeraro0Carlo Maria Cipolla1Daniela Maria Cardinale2Cardioncology Unit, European Institute of Oncology, IRCCS<sup>†</sup>, 20145 Milan, ItalyCardioncology and Second Opinion Division, European Institute of Oncology, IRCCS<sup>†</sup>, 20145 Milan, ItalyCardioncology Unit, European Institute of Oncology, IRCCS<sup>†</sup>, 20145 Milan, ItalyIn patients with cancer—and especially some specific subtypes—the heart can be pathologically affected due to the direct action of the tumor or its secretion products or due to the toxicity of some oncological treatments. Cardiac biomarkers have been investigated as inexpensive and easily accessible tools for prediction, early diagnosis, monitoring, or prognosis of various forms of cancer-related cardiac diseases. However, their clinical usefulness was not always clearly demonstrated in every area of cardioncology. For the identification of anthracycline related cardiotoxicity in the very early stages troponins proved to be more efficient detectors than imaging methods. Nevertheless, the lack of a standardized dosage methodology and of cardiotoxicity specific thresholds, do not yet allow to outline the precise way to employ them in clinical routine and to incorporate them into appropriate diagnostic or managing algorithms. Cardiac biomarkers proved also effective in patients with primary cardiac amyloidosis, in which both troponins and natriuretic peptides were able to predict adverse outcome, and carcinoid heart disease, where a precise diagnostic cut-off for N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was identified to screen patients with valvular involvement. Likewise, NT-proBNP proved to be an excellent predictor of postoperative atrial fibrillation (POAF). On the contrary, evidence is still not sufficient to promote the routine use of cardiac biomarkers to early diagnose myocarditis due to immune check points inhibitors (ICIs), radiotherapy induced cardiotoxicity and cardiac complications related to androgenetic deprivation. In this review we present all the evidence gathered so far regarding the usefulness and limitations of these relatively inexpensive diagnostic tools in the field of cardio-oncology.https://www.mdpi.com/2072-6694/13/21/5426androgen deprivationcarcinoidcardiac amyloidosiscardiac biomarkerscardio-oncologycardiotoxicity |
| spellingShingle | Gennaro Carmine Semeraro Carlo Maria Cipolla Daniela Maria Cardinale Role of Cardiac Biomarkers in Cancer Patients Cancers androgen deprivation carcinoid cardiac amyloidosis cardiac biomarkers cardio-oncology cardiotoxicity |
| title | Role of Cardiac Biomarkers in Cancer Patients |
| title_full | Role of Cardiac Biomarkers in Cancer Patients |
| title_fullStr | Role of Cardiac Biomarkers in Cancer Patients |
| title_full_unstemmed | Role of Cardiac Biomarkers in Cancer Patients |
| title_short | Role of Cardiac Biomarkers in Cancer Patients |
| title_sort | role of cardiac biomarkers in cancer patients |
| topic | androgen deprivation carcinoid cardiac amyloidosis cardiac biomarkers cardio-oncology cardiotoxicity |
| url | https://www.mdpi.com/2072-6694/13/21/5426 |
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