Silent damage, early signals: A narrative review of the evolving role of cardiac biomarkers in oncology-driven cardiotoxicity

Authors

Aura Calderon, The University of Texas Rio Grande ValleyFollow
Luis Salcedo, The University of Texas Rio Grande ValleyFollow
Jose Loayza, The University of Texas Rio Grande ValleyFollow
Catherine Matos, The University of Texas Rio Grande ValleyFollow
ivan Mogollon, The University of Texas Rio Grande ValleyFollow
Francisco Arias, The University of Texas Rio Grande ValleyFollow
Everardo Cobos, The University of Texas Rio Grande ValleyFollow

Document Type

Article

Publication Date

9-2025

Abstract

Advancements in cancer therapy have led to improved patient survival but have also introduced an increasing risk of cardiotoxicity, particularly with agents such as anthracyclines, trastuzumab, and various targeted treatments. Cardiotoxic effects may present as myocardial injury, systolic or diastolic dysfunction, or heart failure (HF), often developing insidiously before clinical symptoms become evident. Early detection is therefore crucial to preserve cardiovascular health in oncology patients. This narrative review examines the expanding role of cardiac biomarkers; including high-sensitivity troponins, natriuretic peptides, Galectin-3, soluble ST2, and novel molecular markers like microRNAs, in identifying and monitoring chemotherapy-induced cardiac injury. It also highlights how these biomarkers complement advanced imaging techniques such as global longitudinal strain, cardiac magnetic resonance, and myocardial deformation imaging to detect subclinical changes before ejection fraction declines. Furthermore, we explore the clinical relevance of biomarker-guided monitoring, the role of cardioprotective agents such as dexrazoxane, and the emerging utility of stress-based functional testing in evaluating cardiac reserve. Overall, the review emphasizes a tailored, multimodal approach that integrates biomarkers, imaging, and clinical risk profiling to enhance early intervention and sustain cancer treatment without compromising cardiac function.

Comments

© 2025 American Federation for Medical Research.   This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page  

Recommended Citation

Aura, C., Salcedo, L., Loayza Pintado, J., Matos, C., Mogollon, I., Arias, F., & Cobos, E. (2025). Silent damage, early signals: A narrative review of the evolving role of cardiac biomarkers in oncology-driven cardiotoxicity. Journal of Investigative Medicine, 10815589251382263. https://doi.org/10.1177/10815589251382263

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Journal of Investigative Medicine

DOI

10.1177/10815589251382263

Academic Level

faculty

Mentor/PI Department

Internal Medicine