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Left ventricular dysfunction predicted by early troponin I release after high-dose chemotherapy

Daniela Cardinale, MD^a, Maria Teresa Sandri, MD, Alessandro Martinoni, MD^a, Alessio Tricca LabTech, Maurizio Civelli, MD^a, Giuseppina Lamantia, MD^a, Saverio Cinieri, MD^*, Giovanni Martinelli, MD^*, Carlo M. Cipolla, MD^a and Cesare Fiorentini, MD^a

^a Cardiology Unit, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
^* Hematoncology Unit, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
Laboratory Medicine, Istituto Europeo di Oncologia, University of Milan, Milan, Italy

View larger version (13K): [in a new window]   Figure 1 Study design. Open square = clinical and echocardiographic examination; Open circle = troponin I, creatine kinase (CK) and CK-MB mass determination. EC = epirubicin and cyclophosphamide; ICE = ifosfamide, carboplatin and etoposide; SEQ = sequential therapy (see Table 1); TEC = taxotere, epirubicin and cyclophosphamide; TICE = taxotere, ifosfamide, carboplatin and etoposide.

View larger version (12K): [in a new window]   Figure 2 Left ventricular ejection fraction (LVEF) at baseline and during the seven months of follow-up of troponin I positive (cTnI+; solid circle) and negative (cTnI–; solid square) patients. *p < 0.001 vs. baseline (month 0); p < 0.001 vs. cTnI– group. Data are shown as mean ± 95% confidence interval.

View larger version (16K): [in a new window]   Figure 3 Maximal percent changes in end-diastolic volume (EDV), end-systolic volume (ESV) and left ventricular ejection fraction (LVEF) observed during the follow-up in the two groups of patients. cTnI+ = cardiac troponin I > 0.4 ng/ml; cTnI– = cardiac troponin I 0.4 ng/ml. Data are shown as mean ± 95% confidence interval.

View larger version (13K): [in a new window]   Figure 4 Scatterplot of left ventricular ejection fraction (LVEF) changes against troponin I value in cTnI+ patients. cTnI = cardiac troponin I.