Estadísticas

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        "resumen" => "Antes de indicar la terapia antrac&#237;clica es necesario monitorear los factores de riesgo modificables &#40;hipertensi&#243;n&#41; y establecer el estado cardiovascular basal&#44; midiendo la fracci&#243;n de expulsi&#243;n y la funci&#243;n diast&#243;lica por ecocardiograf&#237;a&#46; Marcadores como troponina C o I y el p&#233;ptido natriur&#233;tico cerebral &#40;BNP&#41; indican la magnitud del da&#241;o cardiaco y disfunci&#243;n subcl&#237;nica temprana&#46; La dosis acumulada de antraciclina es factor de riesgo importante de cardiotoxicidad&#44; por lo que debe usarse la menor dosis terap&#233;utica&#46; En adultos&#44; la infusi&#243;n lenta &#40;48 o 96 horas&#41; es mejor tolerada que la administraci&#243;n en bolos&#46; Las preparaciones liposomales y pegiladas disminuyen considerablemente el riesgo&#46; No todos los antioxidantes han demostrado utilidad&#46; El quelante&#44; dexrazoxane&#44; remueve el hierro del complejo antraciclina-hierro o atrapa el hierro libre e impide la formaci&#243;n de especies reactivas de ox&#237;geno&#44; reduciendo el riesgo de insuficiencia cardiaca en pacientes adultos&#46; En ni&#241;os&#44; la evidencia es menos s&#243;lida&#44; aunque dexrazoxane disminuye la concentraci&#243;n de troponina en los expuestos a antraciclinas&#46; Varios moduladores del eje renina angiotensina impiden los cambios funcionales tempranos de cardiotoxicidad por antraciclinas&#46; El monitoreo a largo plazo se realiza mediante cl&#237;nica&#44; electrocardiograma&#44; ecocardiograma y mediciones seriadas de troponina y BNP&#46;"
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