Brain natriuretic peptide is a predictor of anthracycline-induced cardiotoxicity

Anthracyclines are effective antineoplastic drugs, but they frequently caus e dose-related cardiotoxicity. The cardiotoxicity of conventional anthracyc line therapy highlights a need to search for methods that are highly sensit ive and capable of predicting cardiac dysfunction. We measured the plasma l evel of brain natriuretic peptide (BNP) to determine whether BNP might serv e as a simple diagnostic indicator of anthracycline-induced cardiotoxicity in patients with acute leukemia treated with a daunorubicin (DNR)-containin g regimen. Thirteen patients with acute leukemia were treated with a DNR-co ntaining regimen. Cardiac functions were evaluated with radionuclide angiog raphy before chemotherapies. The plasma levels of atrial natriuretic peptid e (ANP) and BNP were measured at the time of radionuclide angiography. Thre e patients developed congestive heart failure after the completion of chemo therapy. Five patients were diagnosed as having subclinical heart failure a fter the completion of chemotherapy. The plasma levels of BNP in all the pa tients with clinical and subclinical heart failure increased above the norm al limit (40 pg/ml) before the detection of clinical or subclinical heart f ailure by radionuclide angiography. On the other hand, BNP did not increase in the patients without heart failure given DNR, even at more than 700 mg/ m(2). The plasma level of ANP did not always increase in all the patients w ith clinical and subclinical heart failure. These preliminary results sugge st that BNP may be useful as an early and sensitive indicator of anthracycl ine-induced cardiotoxicity, Copyright (C) 2001 S. Karger AG, Basel.