Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker.
<h4>Background</h4>Adriamycin (doxorubicin hydrochloride) is a widely used chemotherapeutic agent for treating various malignancies. However, its most significant adverse effect is cardiac toxicity. Early detection of Adriamycin-induced cardiac dysfunction is crucial in preventing heart...
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2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0328632 |
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| author | Mina Farshidgohar Majid Vafaie Sonia Oveisi Maryam Bakhshi |
| author_facet | Mina Farshidgohar Majid Vafaie Sonia Oveisi Maryam Bakhshi |
| author_sort | Mina Farshidgohar |
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| description | <h4>Background</h4>Adriamycin (doxorubicin hydrochloride) is a widely used chemotherapeutic agent for treating various malignancies. However, its most significant adverse effect is cardiac toxicity. Early detection of Adriamycin-induced cardiac dysfunction is crucial in preventing heart failure through interventions such as angiotensin-converting enzyme inhibitors and beta-blockers. Adriamycin-induced cardiotoxicity is classified into Type I (irreversible, involving cardiomyocyte necrosis) and Type II (potentially reversible, involving cardiomyocyte dysfunction). Type I toxicity is more common, leading to long-term heart cell necrosis. Monitoring cardiac function in children receiving Adriamycin is essential. Non-invasive imaging techniques like transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography are used to evaluate left ventricular (LV) systolic and diastolic functions. However, the role of cardiac Troponin I for early detection of anthracycline-induced cardiomyopathy remains debated.<h4>Methods</h4>This prospective study included 50 children (26 males, 24 females) with a median age of 8 years (range: 2-14) receiving Adriamycin. Troponin I levels were measured before and 24 hours after Adriamycin administration. Standard Doppler Echocardiography and Tissue Doppler Imaging (TDI) were performed at baseline, one month, and six months' post-treatment to assess LV function.<h4>Results</h4>Out of 50 patients, two showed a decrease in left ventricular ejection fraction (LVEF) below the normal range (<55%) one month post-treatment, along with significant increases in Troponin I levels. No significant decline in LVEF was observed at one or six months' post-treatment using Standard Doppler Echocardiography. However, TDI revealed a decrease in LV systolic and diastolic function in all patients one month after Adriamycin administration.<h4>Conclusion</h4>TDI is more sensitive than Standard Doppler Echocardiography in detecting Adriamycin-induced cardiotoxicity. Elevated cardiac Troponin I levels correlate with a decline in LVEF, but subclinical cardiac dysfunction is better detected with TDI. |
| format | Article |
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| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-536d5f230a6440118cfaa0387abfa3bc2025-08-23T05:32:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01208e032863210.1371/journal.pone.0328632Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker.Mina FarshidgoharMajid VafaieSonia OveisiMaryam Bakhshi<h4>Background</h4>Adriamycin (doxorubicin hydrochloride) is a widely used chemotherapeutic agent for treating various malignancies. However, its most significant adverse effect is cardiac toxicity. Early detection of Adriamycin-induced cardiac dysfunction is crucial in preventing heart failure through interventions such as angiotensin-converting enzyme inhibitors and beta-blockers. Adriamycin-induced cardiotoxicity is classified into Type I (irreversible, involving cardiomyocyte necrosis) and Type II (potentially reversible, involving cardiomyocyte dysfunction). Type I toxicity is more common, leading to long-term heart cell necrosis. Monitoring cardiac function in children receiving Adriamycin is essential. Non-invasive imaging techniques like transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography are used to evaluate left ventricular (LV) systolic and diastolic functions. However, the role of cardiac Troponin I for early detection of anthracycline-induced cardiomyopathy remains debated.<h4>Methods</h4>This prospective study included 50 children (26 males, 24 females) with a median age of 8 years (range: 2-14) receiving Adriamycin. Troponin I levels were measured before and 24 hours after Adriamycin administration. Standard Doppler Echocardiography and Tissue Doppler Imaging (TDI) were performed at baseline, one month, and six months' post-treatment to assess LV function.<h4>Results</h4>Out of 50 patients, two showed a decrease in left ventricular ejection fraction (LVEF) below the normal range (<55%) one month post-treatment, along with significant increases in Troponin I levels. No significant decline in LVEF was observed at one or six months' post-treatment using Standard Doppler Echocardiography. However, TDI revealed a decrease in LV systolic and diastolic function in all patients one month after Adriamycin administration.<h4>Conclusion</h4>TDI is more sensitive than Standard Doppler Echocardiography in detecting Adriamycin-induced cardiotoxicity. Elevated cardiac Troponin I levels correlate with a decline in LVEF, but subclinical cardiac dysfunction is better detected with TDI.https://doi.org/10.1371/journal.pone.0328632 |
| spellingShingle | Mina Farshidgohar Majid Vafaie Sonia Oveisi Maryam Bakhshi Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker. PLoS ONE |
| title | Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker. |
| title_full | Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker. |
| title_fullStr | Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker. |
| title_full_unstemmed | Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker. |
| title_short | Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker. |
| title_sort | early detection of cardiotoxicity in children receiving adriamycin a comparison of tissue doppler and standard echocardiography with troponin i as an early marker |
| url | https://doi.org/10.1371/journal.pone.0328632 |
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