Trial Information

Evolution Natriuretic Peptide Concentrations of B-type (BNP) During General Anesthesia Under Propofol and Sevoflurane Association in Patients Previously Sensitized to Anthracyclines. Pilot Study in Patients Operated on for Breast Cancer. Monocentric Study Feasibility.

The cardiotoxicity of anthracyclines chemotherapy remains a major problem, despite clinical
and echocardiographic monitoring. In the case of treatment for breast cancer, surgery
requiring general anesthesia may follow chemotherapy. Although a possible interaction
between general anesthetics and anthracyclines on systolic function is only rarely
mentioned, some cases of heart failure and / or conduction disturbances peranesthésique were
observed in patients treated or previously treated with anthracyclines. The determination of
concentration of BNP is a diagnostic tool used in the detection of heart failure and acute
coronary syndromes. In fact, it is one of the most sensitive markers of impaired myocardial
function, and an increase in interest rates may precede any other biological changes. In a
patient who received anthracycline, although it remains asymptomatic elevation of NT-proBNP
concentration may persist for some months after exposure, and that, whatever the doses
received. The question of a possible synergism between cardiotoxic anthracyclines and
anesthetic agents arises. Given its minimally invasive nature and its diagnostic value, the
BNP assay might thus allow to highlight a possible subclinical deficiency. To our knowledge,
there is very little data regarding a possible synergism between cardiotoxic anthracyclines
and anesthetic agents.