Two common biomarkers can predict heart risk in asymptomatic childhood cancer survivors

Medical Xpress / St. Jude Children's Research Hospital / Journal of Clinical Oncology ^ | Jan. 11, 2024 | Matthew J. Ehrhardt et al

[ConservativeMind]

Data from the St. Jude lifetime cohort study (St. Jude LIFE) have revealed that two common biomarkers of cardiac function and damage could better predict cardiomyopathy within five years than routine clinical evaluations in high-risk, asymptomatic childhood cancer survivors. Early detection through screening using these two biomarkers may lead to earlier treatment to prevent and protect against further heart damage.

Cardiomyopathy is often asymptomatic at onset and thus "invisible" to routine clinical evaluations. Scientists found that two common biomarkers, global longitudinal strain (GLS) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP), could identify survivors with otherwise normal-appearing heart function who are at elevated risk of decline in heart muscle function.

The results showed an increase in predicting asymptomatic heart damage in patients treated with potent anthracycline chemotherapy drugs, such as doxorubicin.

Cardiac function is typically assessed using echocardiograms, which look at the volume of blood pumped through part of the heart. The most common measure of that volume is called left ventricular ejection fraction. Many childhood cancer survivors appear to have a normal ejection fraction, only to later develop cardiomyopathy. Findings showed that even in survivors with normal ejection fraction, abnormal GLS and NT-proBNP improved the ability to predict cardiomyopathy risk.

"A survivor with a normal ejection fraction at baseline with abnormal ranges of both biomarkers was at a fourfold increased risk for a worsening ejection fraction in the next five years," Ehrhardt said.

NT-proBNP is a serum biomarker, a chemical released into the bloodstream in greater quantities when the heart is injured or overworked. It is frequently used in adult cardiac patients to identify potential heart injury.

"One of the promising aspects of our findings is that both of these measures are readily available and, therefore, have the potential to impact care more immediately," Ehrhardt said.

[ConservativeMind]

Cancer survivors who used drugs like doxorubicin, daunorubicin, epirubicin and idarubicin should be periodically tested for “global longitudinal strain (GLS)” and “N-terminal-pro-B-type natriuretic peptide (NT-proBNP).”

This will help with early interventional heart treatment.

[ConservativeMind]

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