Jacc: Cardiooncology最新文献

{"title":"Cardiac Effects of Modern Breast Radiation Therapy in Patients Receiving Systemic Cancer Therapy","authors":"Eva Berlin MD ,&nbsp;Kyunga Ko MS ,&nbsp;Lin Ma PhD ,&nbsp;Ian Messing MD ,&nbsp;Casey Hollawell MD ,&nbsp;Amanda M. Smith BA, MA ,&nbsp;Neil K. Taunk MD, MSCTS ,&nbsp;Vivek Narayan MD, MSCE ,&nbsp;Jenica N. Upshaw MD, MS ,&nbsp;Amy S. Clark MD ,&nbsp;Payal D. Shah MD ,&nbsp;Hayley Knollman MD ,&nbsp;Saveri Bhattacharya DO ,&nbsp;Daniel Koropeckyj-Cox BA ,&nbsp;Jessica Wang BA ,&nbsp;Nikhil Yegya-Raman MD ,&nbsp;Ivy S. Han BS ,&nbsp;Benedicte Lefebvre MD ,&nbsp;Tang Li MS ,&nbsp;Nicholas S. Wilcox MD ,&nbsp;Bonnie Ky MD, MSCE","doi":"10.1016/j.jaccao.2025.01.012","DOIUrl":"10.1016/j.jaccao.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Radiation therapy (RT) improves breast cancer outcomes, but cardiac morbidity remains a concern.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate changes in cardiac function after RT and the relationship between cardiac dose metrics and echocardiography-derived measures of function.</div></div><div><h3>Methods</h3><div>In a longitudinal cohort study of women with breast cancer, radiation cardiac dose metrics and core lab quantitated echocardiographic measures of cardiac function were evaluated. Dose metrics included the whole heart, left ventricle, right ventricle, and left anterior descending artery (LAD). Echocardiographic measures included left ventricular ejection fraction (LVEF), longitudinal strain, circumferential strain, E/e’ (ratio of early diastolic mitral inflow velocity to early diastolic mitral annular tissue velocity), Ea/Es (ventricular arterial coupling; ratio of effective arterial elastance to end systolic elastance), and right ventricular fractional area change. The mean change in echocardiographic measures over time and the association between cardiac dose metrics and echocardiographic measures were estimated by repeated-measures multivariable linear regression via generalized estimating equations.</div></div><div><h3>Results</h3><div>The cohort included 303 participants (median age 52 years, 33.3% African American) who received adjuvant RT (2010-2019) with a median mean heart dose of 1.19 Gy (Q1-Q3: 0.75-2.61 Gy), were followed over a median of 5.1 years (Q1-Q3: 3.2-7.1 years). Across all participants, there was a modest increase in LVEF (52.1% pre-RT to 54.3% at 5 years; <em>P &lt;</em> 0.001) but a worsening in sensitive measures of function, such as circumferential strain (−23.7% pre-RT to −21.0% at 5 years; <em>P =</em> 0.003). Among left-sided/bilateral breast cancer participants, changes in cardiac function were observed across all parameters (<em>P &lt;</em> 0.05). The maximum LAD dose was associated with a modest worsening in LVEF, longitudinal strain, circumferential strain, and E/e′.</div></div><div><h3>Conclusions</h3><div>Over a median of 5.1 years, modest changes in cardiac function were observed with RT. Maximum LAD dose was associated with a worsening in systolic and diastolic function parameters.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 219-230"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Stratification for Trastuzumab-Induced Cardiac Dysfunction and Potential Implications for Surveillance","authors":"Abdelrahman Ali MD ,&nbsp;Efstratios Koutroumpakis MD ,&nbsp;Juhee Song PhD ,&nbsp;Daniel Booser MD ,&nbsp;Carlos H. Barcenas MD, MSc ,&nbsp;Debu Tripathy MD ,&nbsp;Ana Barac MD, PhD ,&nbsp;Nicolas L. Palaskas MD, MPH ,&nbsp;Anita Deswal MD, MPH","doi":"10.1016/j.jaccao.2024.12.007","DOIUrl":"10.1016/j.jaccao.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Although patient factors and sequential anthracycline use contribute to risk for cancer therapy–related cardiac dysfunction (CTRCD) with HER2-directed cancer therapy, frequent (every 3 months) left ventricular ejection fraction (LVEF) surveillance is recommended irrespective of baseline risk.</div></div><div><h3>Objectives</h3><div>The aim of this study was to examine the incidence of trastuzumab-associated CTRCD in a contemporary cohort with HER2-positive breast cancer and assess the performance of a risk assessment tool to identify patients at low risk for CTRCD to guide risk-based surveillance strategies.</div></div><div><h3>Methods</h3><div>A retrospective cohort of patients with HER2-positive breast cancer treated with trastuzumab at a tertiary cancer center was examined. Patients were categorized as low, medium, and high or very high risk for CTRCD by Heart Failure Association/International Cardio-Oncology Society risk assessment.</div></div><div><h3>Results</h3><div>Of 496 patients treated with trastuzumab, 29.8% also received anthracyclines. Over a median follow-up period of 51 months, 8.7% developed CTRCD, but only 1.6% had associated heart failure (HF). CTRCD rates were 3.6%, 12.8%, and 32.1% in low-risk, medium-risk, and high or very high risk groups, respectively. HF incidence was 0.4% in the low-risk group and 2.1% in the medium-risk group, with no HF in patients at low- or medium-risk who received trastuzumab without anthracyclines. HF was observed in 11% of high-risk patients. The risk assessment had a negative predictive value for CTRCD in low vs moderate- or high-risk patients of 96.4% (95% CI: 93.5%-98.3%).</div></div><div><h3>Conclusions</h3><div>The findings support the exploration of a prospective personalized risk-based approach to cardiac LVEF surveillance during trastuzumab therapy. Less frequent LVEF monitoring in low-risk patients may optimize resource use and reduce patient burden without compromising safety.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 203-215"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rechallenge After Severe Immune Checkpoint Inhibitor Myocarditis","authors":"Guillaume Bailly MD ,&nbsp;Maxime Robert-Halabi MD ,&nbsp;Pierre-Adrien Vion MD ,&nbsp;Yves Allenbach MD, PhD ,&nbsp;Baptiste Abbar MD, PhD ,&nbsp;Marie Bretagne MD ,&nbsp;Joe-Elie Salem MD, PhD","doi":"10.1016/j.jaccao.2025.02.004","DOIUrl":"10.1016/j.jaccao.2025.02.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 300-304"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Aortic Stenosis and Chronic Myeloid Leukemia","authors":"Rebecca Cunningham MD, PhD ,&nbsp;Sang Gune K. Yoo MD ,&nbsp;Alexander A. Brescia MD, MSc ,&nbsp;Karolyn A. Oetjen MD, PhD ,&nbsp;Iskra Pusic MD, MSCI ,&nbsp;Joshua D. Mitchell MD, MSCI","doi":"10.1016/j.jaccao.2025.01.010","DOIUrl":"10.1016/j.jaccao.2025.01.010","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 305-308"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Articulating the JACC Journals’ Direction in Times of Global Change","authors":"Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC),&nbsp;Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure),&nbsp;Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging),&nbsp;Bonnie Ky MD, MSCE (Editor-in-Chief, JACC: CardioOncology),&nbsp;Douglas L. Mann MD (Editor-in-Chief, JACC: Basic to Translational Science),&nbsp;David J. Moliterno MD (Editor-in-Chief, JACC: Cardiovascular Interventions),&nbsp;Kalyanam Shivkumar MD, PhD (Editor-in-Chief, JACC: Clinical Electrophysiology),&nbsp;Candice K. Silversides MD (Editor-in-Chief, JACC: Advances),&nbsp;Gilbert H.L. Tang MD, MSc, MBA (Editor-in-Chief, JACC: Case Reports),&nbsp;Jian’an Wang MD, PhD (Editor-in-Chief, JACC: Asia)","doi":"10.1016/j.jaccao.2025.02.001","DOIUrl":"10.1016/j.jaccao.2025.02.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 322-323"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enalapril for Preventing Cardiotoxicity After High-Dose Anthracycline Therapy in Breast Cancer and Lymphoma Patients","authors":"Daniela Cardinale MD, PhD ,&nbsp;Giancarlo Marenzi MD","doi":"10.1016/j.jaccao.2025.01.014","DOIUrl":"10.1016/j.jaccao.2025.01.014","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 317-318"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Checkpoint Inhibitor–Related Myocarditis With or Without Concomitant Myopathy","authors":"Osnat Itzhaki Ben Zadok MD, MSc ,&nbsp;Meabh J. O’Hare MBBCH ,&nbsp;Anju Nohria MD, MSc","doi":"10.1016/j.jaccao.2025.02.005","DOIUrl":"10.1016/j.jaccao.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Data on cardiovascular outcomes in patients with both immune checkpoint inhibitor–induced immune-related myocarditis (irMyocarditis) and immune-related myopathy (irMyopathy) are limited.</div></div><div><h3>Objectives</h3><div>The aim of this study was to describe clinical characteristics and cardiovascular outcomes in patients with isolated irMyocarditis vs those with concomitant irMyocarditis and irMyopathy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted among patients diagnosed with irMyocarditis at Massachusetts General Brigham between 2015 and 2023. Clinical, laboratory, and imaging characteristics were evaluated, and cardiovascular outcomes were compared between patients with and those without concomitant irMyopathy. The outcomes assessed included acute heart failure requiring diuresis, significant arrhythmias (ventricular arrhythmias and high-degree atrioventricular block), and cardiovascular and all-cause mortality during the index hospitalization.</div></div><div><h3>Results</h3><div>Among 101 patients with irMyocarditis, 32 (31.7%) had concomitant irMyopathy. Patients with irMyocarditis and irMyopathy had higher high-sensitivity troponin T (median 716 ng/L vs 75 ng/L; <em>P</em> &lt; 0.001) and creatine kinase levels (median 3441 U/L vs 232 U/L; <em>P</em> &lt; 0.001) and were more likely to present with significant arrhythmias (HR: 2.12; 95% CI: 1.13-3.97; <em>P</em> = 0.019). Conversely, patients with isolated irMyocarditis had higher N-terminal prohormone of brain natriuretic peptide levels (median 2043 pg/mL vs 606 pg/mL; <em>P</em> = 0.007), lower left ventricular ejection fractions (median 56% vs 65%; <em>P</em> = 0.008), and a higher likelihood of acute decompensated heart failure (HR: 5.88; 95% CI: 1.45-25; <em>P</em> = 0.013). Cardiovascular and all-cause death during admission were numerically higher in patients with concomitant irMyopathy but were not significantly different between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Patients with irMyocarditis and irMyopathy and those with isolated irMyocarditis have distinct biomarker profiles and cardiovascular complications. These differences should be confirmed in larger prospective cohorts to guide tailored management strategies.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 252-264"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Checkpoint Inhibitor-Related Myocarditis, Myopathy, and More","authors":"Jafar Al-Mondhiry MD, MA ,&nbsp;Ana Barac MD, PhD","doi":"10.1016/j.jaccao.2025.03.004","DOIUrl":"10.1016/j.jaccao.2025.03.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 265-267"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Mean Heart Dose","authors":"Sophie Jacob PhD ,&nbsp;Youlia Kirova MD, PhD ,&nbsp;Eloi Marijon MD, PhD","doi":"10.1016/j.jaccao.2025.03.002","DOIUrl":"10.1016/j.jaccao.2025.03.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 231-233"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Trastuzumab-Induced Cardiac Dysfunction Risk Stratification and Surveillance","authors":"Fengqi Fang MD ,&nbsp;Xinxin Zhang MD ,&nbsp;Junjie Li MD","doi":"10.1016/j.jaccao.2025.01.011","DOIUrl":"10.1016/j.jaccao.2025.01.011","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 216-218"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}