Kilickap S et al. (2005) cTnT can be a useful marker for early detection of anthracycline cardiotoxicity. Ann Oncol 16: 798–804

Cardiotoxicity is a serious side-effect of the antineoplastic ANTHRACYCLINES. Kilickap et al. have recently investigated whether serum levels of CARDIAC TROPONIN T (CTNT), associated with myocardial damage, can act as a marker for early detection of anthracycline-induced cardiotoxicity.

Between October 2001 and October 2002, 41 patients due to undergo anthracycline therapy for various malignancies, were enrolled in the study. Echocardiography was performed before and after treatment, to assess systolic cardiac function parameters (left-ventricular ejection fraction and fractional shortening), and diastolic indicators (E/A RATIO and isovolemic relaxation time). Serum cTnT levels were determined before, during and after anthracycline therapy. The mean cumulative anthracycline dose was 228 mg/m2 (range 50–480 mg/m2).

After a mean follow up of 6.3 months (range 2–11 months), serum cTnT levels were elevated above baseline in 14 patients, although they exceeded the upper limit of normal in only one case. The E/A ratio decreased after treatment in 20 patients. This outcome was more prevalent in the older age group (>44 years). In the younger age group (≤44 years) 3 of 14 patients with elevated cTnT levels had a decreased E/A ratio compared with 3 of 27 patients with normal cTnT levels. Left-ventricular ejection fraction and fractional shortening were not altered by treatment in any of the patients. The investigators concluded that elevated levels of cTnT associated with reduced diastolic cardiac function can be detected in the early stages of anthracycline therapy, and could therefore be a useful marker of cardiotoxicity.