Cardio-oncology and functional outcomes: Top contributors, and content analysis of the global research literature (1974-2025).

Abstract

This bibliometric analysis examined global research on cardio-oncology, cardiotoxicity, cancer survivorship, and functional outcomes using Scopus-indexed publications (1974-2025). The results demonstrate exponential growth in output, particularly after 2000, reaching a peak in 2024. Among authors, Cardinale, D. led with 16 publications, followed by Lipshultz, S.E. (14) and Guha, A. (12). The most productive institutions included The University of Texas MD Anderson Cancer Center (60), and Harvard Medical School (48). At the country level, the United States dominated output (919 publications), followed by Italy (313) and the United Kingdom (241). Analysis of the top 100 most cited publications (1987-2024) showed a a mean citation rate of 115.3 per document. Co-word dynamics revealed an evolution from chemotherapy-centered toxicity (e.g., doxorubicin) toward integrated frameworks involving cardiovascular outcomes, mechanistic pathways such as oxidative stress, and survivorship concerns. The formal emergence of "cardio-oncology" after 2018 marked consolidation of the field. Content analysis of the top 50 publications highlighted anthracycline-induced cardiotoxicity, biomarker and imaging-based early detection, and multidisciplinary care models. Key mechanisms included oxidative stress, mitochondrial dysfunction, and ferroptosis, while disparities in socioeconomic and demographic factors were increasingly recognized. Overall, the evidence indicates a shift toward integrated, patient-centered strategies balancing cancer control with preservation of cardiovascular and functional health.