Validation of novel predictors for early detection of cancer therapeutics-related cardiac dysfunction

Early identification of cardiotoxicity of chemotherapy is crucial. Gene expression is considered a promising tool.

To validate the new speckle tracking values, high-sensitive (Hs) troponin and expression of TNNI3K and RyR2 genes for early detection of cardiotoxicity.

Fifty patients with cancer breast on Anthracycline chemotherapy were subjected to speckle tracking echocardiography and Hs troponin measurement. Relative expression of TNNI3K and RyR2 genes were determined by RT-PCR.

Fifty female patients with age (43.89 ± 6.4) were included. Fourteen patients (28%) developed cardiotoxicity, diagnosed by decrease GLS > 15%. Compared to GLS, Hs-Troponin has sensitivity 73%, specificity 100%, PPV 78.5% and NPV 100%. Cutoff point of GLS > 10% had sensitivity 95%, specificity 78%, PPV 81% and NPV 84%. Using a cutoff of 24% change in TNNI3K Expression; sensitivity 100%, specificity 74%, PPV 79.5% and NPV 100%. Using a cutoff of 25% in RYR-2 expression; sensitivity 67% and specificity 59% with less PPV and NPV (62% and 64%). Adding GLS change >10% to Hs troponin and TNNI3K expression resulted in highest sensitivity (100%) and specificity (95.5%) with 96% PPV and 100% NPV.

Cutoff point of GLS > 10%, Hs-Troponin and TNNI3K gene expression are reliable test for early detection of cardiotoxicity.

042024100222.