Anthracycline mediated cardiotoxicity: Detection of miRNA based early biomarkers for the prediction of myocardial injury. Hecatos study

Abstract

Background: An improvement in the diagnosis and treatment of cancer has been shown in recent years with a significant increase in survival. Systemic therapies have an impact on reducing the risk for recurrence and mortality. However, there are potential long‐term sequel like cardiac toxicity which could be a long‐term determinant of quality of life. The principal aim is to identified predictive biomarkers related to acute and later cardiotoxic. HeCaTos Study Methods: Multicenter, prospective, observational study. 400 patients diagnosed with breast cancer, lymphoma or leukemia treated with adjuvant chemotherapy (CT) (antracyclines) and 10 years of follow‐up. There were analysed 97 patients with breast cancer treated with adjuvant therapies. A selected group of 25 patients was use to analyze variations in miRNA expression levels using qPCR. Cardiotoxicity was defined by left ventricular ejection fraction (LVEF) reduction >5% with LVEF < 55% and symptoms of heart failure or LVEF reduction > 10% with LVEFT < 55% in asymptomatic Results: Table 1 describes patient characteristics. LVEF and longitudinal strain are the most reliable indicators of drug induced cardiotoxicity. There was a decrease in LVEF (<55%) with a LVEF reduction >10% in 6,3% patients. Longitudinal strain was affected in 18% of patients and Troponin T was pathological in 29% of cases. We found a correlation among the decrease in LVEF and miRNA‐208 associated with congestive heart failure (P < 0.02). Conclusions: Decrease in LVEF, related to adjuvant CT, is correlated with an increase of congestive heart failure associated miRNA. Also, there was an increase of troponin levels after last CT cycle and variations in miRNA expression levels. Among them we found a strong correlation between the decrease in LVEF and the increase in miRNA 208 levels in serum of patients during CT. Further studies must be performed to evaluate the impact of these observations in the cardiotoxic process. (Table Presented).