Mitochondrial Ferritin in Subclinical Anthracycline-Induced Cardiotoxicity in Humans: A Pilot Study

This study investigated the effects of anthracyclines on mitochondrial ferritin (MtFt) expression in primary murine cardiomyocytes and in cancer patients. MtFt expression was first evaluated in murine cardiomyocytes before and after doxorubicin exposure. Subsequently, MtFt levels were assessed in peripheral blood cells of 26 cancer patients at baseline, at the end of treatment, and 12 months after the first cycle, together with high-sensitivity troponin T (hsTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF). Doxorubicin-treated murine cardiomyocytes exhibited increased MtFt expression compared with untreated cells. No patient developed clinically relevant cardiotoxicity. A weak but significant inverse association was observed between MtFt levels and LVEF at the end of treatment. Multivariable linear regression showed no significant predictive effect of hsTnT, NT-proBNP, or time on MtFt changes, although MtFt levels tended to decrease and hsTnT levels to increase over time.