Vnitr Lek 2013, 59(11):996-1002

Role of cardiac biomarkers in monitoring of cardiotoxicity after hematopoietic stem cell transplantation

Ľ. Roziaková^1,2,*, B. Mladosievičová¹

¹ Oddelenie klinickej patofyziológie Ústavu patologickej fyziológie Lekárskej fakulty UK Bratislava, Slovenská republika, prednosta prof. MUDr. Marián Bernadič, CSc.

² Klinika hematológie a transfuziológie Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Martin Mistrík, PhD.

Advances in hematopoietic stem cell transplantation (HSCT) have increased survival in hematologic diseases. However, HSCT survivors are at risk of developing acute and long-term complications. Cardiac events, such as heart failure, myocardial ischemia and arrhythmias may represent potentially life-threatening conditions. Acute cardiotoxicity can occur during the first 100 days after HSCT. Conditioning regimens, including total body irradiation and high-dose chemotherapy, previous chemoradiotherapy, including anthracyclines and chest irradiation, are known to be associated with an increased risk of cardiac complications after HSCT. Infectious complications resulting in sepsis due to post-transplant granulocytopenia may also impair myocardial function. Therefore the main strategy for minimizing cardiotoxicity is early detection of high-risk patients and prompt prophylactic treatment. Measurement of cardiospecific biomarkers can be a valid diagnostic tool for early identification, assessment, and monitoring of cardiotoxicity. In the present article, we review the usefulness of cardiac troponins and natriuretic peptides, the most commonly used biomarkers of myocardial ischemia and ventricular dysfunction, to detect and to predict the development of cardiotoxicity after HSCT.

Keywords: cardiac biomarkers; cardiotoxicity; hematopoietic stem cell transplantation

Received: April 28, 2013; Accepted: July 16, 2013; Published: November 1, 2013  Show citation