Table 2.

Biomarker of elevated left ventricular pressure: natriuretic peptides.

BIOMARKERS	MECHANISMS	MAIN FINDINGS	REF.
Natriuretic Peptides	Release in response to elevation in LV filling pressure and wall stress	Anthracycline:	30,33–36,41,42
		– Correlations between NT-pro-BNP level and cumulative dose
		– NT-pro-BNP levels during the first 90 days after therapy predict cardiotoxicity at 4 years of follow-up
		– BNP > 51.3 ng/L has a 83% sensitivity and 90% specificity for the detection of cardiotoxicity
		– HF symptoms are more common when BNP > 100 pg/mL during follow-up
		Various HDC protocols:
		– Patients with elevated NT-pro-BNP have higher risks of cardiac toxicity, HF progression and death
		– Persistently elevated NT-pro-BNP level at 72 hours is associated with LV systolic/diastolic dysfunction at 12 months of follow-up

Abbreviations: BNP, B-type natriuretic peptide; HDC, high-dose chemotherapy; LVEF, left ventricular ejection fraction.