Review Article
Cardiac Toxicity and Anthracyclines: Mechanism, Interventions, and the Trouble With Troponin
Grace E. Thompson, MSN, AGACNP-BC, AGPCNP-BC, and Phyllis P. Wright, DNP, AGPCNP-BC, MPH
Emory University, Atlanta, Georgia
Authors’ disclosures of conflicts of interest are found at the end of this article.
Grace E. Thompson, MSN, AGACNP-BC, 2554 St. Patrick Street SE, Atlanta, GA 30317. E-mail: grace.e.thompson@gmail.com
J Adv Pract Oncol 2019;10(4):360–366 |
https://doi.org/10.6004/jadpro.2019.10.4.4 |
© 2019 Harborside™
ABSTRACT
Abstract
As cancer survivorship increases, clinicians need to become educated regarding the long-term effect of cancer treatments. Cancer therapeutics–related cardiac dysfunction (CTRCD) is one such sequela that contributes to significant morbidity and mortality. Unfortunately, screening and management practices regarding CTRCD are inconsistent within guidelines and practice. This review will first look at anthracycline-related cardiac dysfunction occurrence and pathophysiology. Current guidelines for CTRCD screening will be discussed, including the use of 2D echocardiograms along with newer technology such as 3D echocardiography and global systolic longitudinal myocardial strain (GLS) measurements. Biomarkers like serum troponin demonstrate promise as an early indicator of cardiomyocyte injury and a potential means of risk stratification; however, guidelines vary regarding how best to incorporate elevated serum troponin levels into management plans. Growing evidence indicates the clinical need for early detection of CTRCD in order to initiate preventative pharmacologic management and improve patient outcomes.
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