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Role of biomarkers and electrocardiography assessment as individual predictors of anthracycline cardiotoxicity in lymphoma patients

100%

Długosz-Danecka M., Jaroszyński A., Jurczak W.

vol. 8

issue 4

99-104

The significant progress in the treatment of non-Hodgkin lymphomas, translating into prolongation of overall survival results in the manifestation of long-term adverse events, like anthracycline-related cardiotoxicity. Despite the dose-dependent cardiac dysfunction and the presence of risk factors, the increasing probability of cardiotoxicity arises from individual predisposition. Identification of high- -risk patients gives the opportunity to implement the prevention strategies to reduce the incidence of cardiac complications. The study evaluated the utility of biomarkers: N-terminal B-type natriuretic peptide, troponin I and electrocardiography with spatial QRS-T angle assessment, as indicators of individual sensitivity of cardiomyocytes to doxorubicin resulting in myocardial damage. Thirty-five treatment-naïve patients at increased risk of cardiotoxicity, were subjected prospectively during (R)-CHOP treatment to echocardiographic assessment and analysis of biomarkers: TnI and NT-proBNP plasma level and spatial QRS-T assessment before and 24 hours after each cycle of chemotherapy. The analysis of QRS-T angle was consistent with the results of NT-proBNP assessment and allowed to identify, after the first cycle of chemotherapy, patients at increased risk of developing cardiovascular complications, who require thorough echocardiographic analysis and primary cardioprotection implementation. Our data did not reveal the role of TnI in the identification of cardiac events. Our findings, though promising, should be confirmed in a larger group of patients in real-life or clinical trials.

Agreement between manual and automated measurements of simple QRS/T angle

64%

Jaroszyński A., Jaroszyńska A., Szcześniak A., Szymczyk A., Zaborowski T., Zapolski T., Wysokiński A., Załuska W.

Open Medicine

2014

vol. 9

issue 6

737-740

The spatial QRS/T angle (QRS/T) has been identified as a strong and independent predictor of adverse cardiac events. QRS/T can be determined from the electrocardiogram (ECG) by matrix transformation methods or formula which uses a combination of net QRS and T-wave amplitudes (QRS/Tsimple). Amplitudes can be measured automatically by using dedicated software (QRS/Tauto) or can be manually measured on a computer screen (QRS/Tmanual). This latter method allows analysis of QRS/T, when digital ECGs are not available. The aim of the study was to determine the agreement in the measurements between automatically derived QRS and T amplitudes and manually measured on the computer screen amplitudes. The relative error of the QRS/T between the two methods was estimated in 73 patients. In the case of QRS/Tmanual the inter-observer as well as intra-observer variability was estimated. The relative error between QRS/Tauto vs. QRS/Tmanual was 3.51%. Inter-observer and intra-observer variability of the QRS/Tmanual was 1.19% and 1.18% respectively. Manual measurement of the QRS/T is reliable, however, the predictive value of this parameter should be tested in clinical trials, before QRS/Tmanual can be considered a useful tool in clinical practice or retrospective studies.

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1 OncoReview

1 Open Medicine

1 2018

1 2014

2 Jaroszyński A.

1 Długosz-Danecka M.

1 Jaroszyńska A.

1 Jurczak W.

1 Szcześniak A.

1 Szymczyk A.

1 Wysokiński A.

1 Zaborowski T.

1 Zapolski T.

1 Załuska W.

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Role of biomarkers and electrocardiography assessment as individual predictors of anthracycline cardiotoxicity in lymphoma patients

Agreement between manual and automated measurements of simple QRS/T angle