Identification of Biomarkers Improves Prediction of Heart Risk in Childhood Cancer Survivors


In a recent study conducted by the St. Jude Children’s Research Hospital, researchers have discovered that two common biomarkers can effectively predict the risk of developing cardiomyopathy in asymptomatic childhood cancer survivors. The study, which utilized data from the St. Jude lifetime cohort study, found that screening for these biomarkers could lead to early detection and treatment, preventing further heart damage.

Cardiomyopathy often goes undetected in its early stages and is invisible to routine clinical evaluations. However, the researchers found that two biomarkers, global longitudinal strain (GLS) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP), could identify childhood cancer survivors with normal-appearing heart function who are at an elevated risk of decline in heart muscle function.

Matthew Ehrhardt, the first and corresponding author of the study, stated that this method of identifying high-risk survivors may lead to earlier interventions, preventing the progression to heart failure. The study results also showed that these biomarkers were particularly effective at predicting heart damage in patients treated with potent anthracycline chemotherapy drugs like doxorubicin, but not in those who only received radiation therapy. This finding may help physicians optimize testing resources by focusing on anthracycline-exposed survivors.

Echocardiograms are commonly used to assess cardiac function, measuring the volume of blood pumped through part of the heart. The most common measure obtained from echocardiograms is the left ventricular ejection fraction. However, many childhood cancer survivors initially show a normal ejection fraction only to later develop cardiomyopathy. The study found that abnormal GLS and NT-proBNP improved the ability to predict the risk of cardiomyopathy, even in survivors with normal ejection fractions.

GLS is an additional measure of heart function derived from echocardiograms and is more sensitive in detecting cardiac muscle injury compared to ejection fraction. GLS is a mathematical estimate of the heart muscle fibers’ ability to contract. On the other hand, NT-proBNP is a serum biomarker that indicates heart injury or overwork by its increased release into the bloodstream. The widespread availability of NT-proBNP makes it a useful tool in identifying potential heart injury in adult cardiac patients.

The study’s findings have significant implications for the early detection and intervention of cardiomyopathy in childhood cancer survivors. By utilizing these readily available biomarkers, physicians can identify survivors at an elevated risk, leading to timely therapeutic interventions. Moreover, early detection can help protect against cardiac damage, as evidenced in adults with other diseases.

The researchers believe that these findings will help identify a high-risk group of survivors who may require closer follow-up or more proactive interventions to reduce the risk of developing cardiomyopathy. Furthermore, the study sets the stage for future research into novel screening and early intervention strategies aimed at improving the cardiac health and overall well-being of childhood cancer survivors.

The study’s authors encourage the implementation of GLS and NT-proBNP as routine screening measures, as they are readily available and have the potential to impact care immediately. By identifying and providing early interventions for childhood cancer survivors at risk of developing cardiomyopathy, healthcare providers can significantly improve outcomes and ensure the long-term cardiac health of these individuals.

1. Source: Coherent Market Insights, Public sources, Desk research
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