| Serum cardiac troponin I levels and ECG/Echo monitoring in breast cancer patients undergoing high-dose (7 g/m(2)) cyclophosphamide. | |
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MedLine Citation:
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PMID: 11535996 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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High-dose cyclophosphamide (HD-CTX) is largely employed in high-dose chemotherapy (HD-CHT) protocols. HD-CTX dose-limiting toxicity expresses itself as cardiac toxicity which is fatal in a minority of patients. The pathophysiology of HD-CTX-associated cardiotoxicity is still poorly understood. Autopsy studies in patients who died from acute HD-CTX-induced cardiac toxicity revealed hemorrhagic myocardial cell death and interstitial edema. Recently troponins, in particular troponin I (cTnI), have been found to represent a uniquely sensitive and specific marker of myocyte membrane integrity and therefore to increase in response to minimal myocardial cell damage in different settings, including doxorubicin-induced cardiotoxicity. We performed a multiparametric cardiologic monitoring in 16 consecutive breast cancer patients undergoing HD-CTX by means of serial ECG registrations and cardiac enzymes (CPK, CPK-MB and cTnI) determinations plus echocardiography in order to clarify acute cardiac events following HD-CTX administration. Neither overt cardiac toxicity nor cardiac enzymes elevation were recorded. Serial ECGs revealed in six cases little and reversible reduction of QRS voltage and/or ST abnormalities. Echo monitoring showed in four cases mild and transient increase of LV diastolic/systolic diameter/volume without decrease of FS% or EF% below normal values: in two of them abnormalities of diastolic function (E/A mitral doppler ratio) were also recorded. We conclude that our protocol of HD-CTX administration does not cause myocardial cell damage as analyzed by serum cTnI levels, thus suggesting that myocyte membrane injury may not be the first direct mechanism of HD-CTX cardiotoxicity. ECG (ie QRS voltages ) and Echo (ie E/A ratio) monitoring leads us to hypothesize that slight interstitial edema with reduction of LV diastolic compliance may be initial signs of cardiac dysfunction in this clinical setting. |
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Authors:
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P Morandi; P A Ruffini; G M Benvenuto; L La Vecchia; G Mezzena; R Raimondi |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Bone marrow transplantation Volume: 28 ISSN: 0268-3369 ISO Abbreviation: Bone Marrow Transplant. Publication Date: 2001 Aug |
Date Detail:
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Created Date: 2001-09-05 Completed Date: 2002-03-07 Revised Date: 2006-04-24 |
Medline Journal Info:
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Nlm Unique ID: 8702459 Medline TA: Bone Marrow Transplant Country: England |
Other Details:
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Languages: eng Pagination: 277-82 Citation Subset: IM |
Affiliation:
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Division of Medical Oncology, San Bortolo Hospital, Vicenza, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antineoplastic Agents, Alkylating / administration & dosage, toxicity* Antineoplastic Combined Chemotherapy Protocols / administration & dosage Biological Markers / blood Breast Neoplasms / complications, drug therapy* Cyclophosphamide / administration & dosage, toxicity* Dose-Response Relationship, Drug Electrocardiography / drug effects* Female Heart Diseases / blood, chemically induced, diagnosis Hematopoietic Stem Cell Transplantation / adverse effects Humans Middle Aged Transplantation, Autologous / adverse effects Troponin I / blood* |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents, Alkylating; 0/Biological Markers; 0/Troponin I; 50-18-0/Cyclophosphamide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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