Diagnóstico oportuno del daño al miocardio en pacientes tratados con antraciclinas: un reto para el siglo XXI Timely diagnosis of myocardial damage in patients treated with anthracyclines: a challenge for the 21 st century

Background. Currently used methods for assessment of myocardial damage in patients treated with anthracyclines are defi cient in detecting mild myocardial damage. Troponin I is part of the protein contractile machinery in the myofi bril and is used as a specifi c biomarker of myocardial damage. The aim of the study was to compare troponin I levels in patients with prior anthracycline use after a new cycle of chemotherapy. Methods. We included patients from 9 to 18 years of age who were diagnosed with cancer and being treated with anthracyclines at the Hospital Infantil de Mexico Federico Gomez. We analyzed serum troponin I prior to and after the new cycle of chemotherapy and compared the results, always in a blinded manner. Results. The mean cumulative dose of anthracyclines in the study population was 234 mg/m 2 SC for daunorubicin and 269 mg/m 2 SC for doxorubicin. There was no signifi cant systolic dysfunction according to echocardiography. Impaired mobility of left ventricular walls was observed using SPECT-CT. There was no evidence of increased levels of troponin I in serum after application of a new dose of anthracyclines. Conclusions. Extensive research has been carried out in regard to biomarkers that aid in the early diagnosis of cardiomyopathy secondary to anthracycline, with mixed results. Taking into account the kinetics of troponin I in myocardial damage is a critical step for evaluation. Using this premise, we did not fi nd an increase of this biomarker in blood after myocardial damage secondary to administration of anthracyclines.