الفهرس 
Cardiac Troponins: Histology, Assay and Clinical ApplicationsOnly 14 pages are availabe for public view
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Abstract
Background:Cardiac contractile dysfunction is the most serious cardiotoxic effect of anthracycline therapy and a major limitation for the use of this effective antineoplastic treatment.
Troponin role in detection of anthracycline cardiotoxicity at high dose has been studied has been studied.
Purpose: To assess the ability of Troponin I and Tissue Doppler imaging to predict early cardiotoxicity at after low total cumulative dose.
Patients and methods: we recruited 30 consecutive patients (25 females 83%) with mean age of 43.5 (±11.97) years; they had various types of cancer and were treated with combined chemotherapy containing doxorubicin. Troponin samples were taken 48 hour post total cumulative dose 250 mg/m2. (Chemotherapy course was 50mg/m2 doxorubicin every 21 days for 6 cycles), conventional echocardiography and TDI were done at before starting chemotherapy and at the end of the chemotherapy course. Paired t-test was used for numerical variables and Chi-square test was used for categorical values.
Results:Despite the small dose chemotherapy Pre and post conventional and TDI echo parameters showed statistically significant increase in the end diastolic dimension (4.777±.5361 , 4.953±.4974, p=0.036) and end systolic dimension (2.867±.5142, 3.107±.4770, p=0.006) between baseline and at the end of the chemotherapy. There was significant reduction in the percentage fraction shortening (40.1%±5.6%, 37.4%±5.7%, p=0.03), ejection fraction (70.1%±7.2%, 64.4%±6.9%, p< 0.001) and systolic lateral mitral annular velocity (10.39±3.150, 8.73±1.964, p=0.005).
There was significant change in the diastolic dysfunction (p=0.005).
Only one patient was found to be troponin positive.
Conclusions:at low dose chemotherapy echocardiography and TDI appears to be valuable in early detection of anthracycline induced cardiotoxicity and could predict further LV dysfunction (systolic and diastolic) on long term follow up. Troponin wasn’t sensitive in early detection of myocardial injury due to anthracycline chemotherapy at low doses.
Key words: Anthracycline cardiotoxicity, troponin, tissue Doppler imaging