Cardio-oncology最新文献

{"title":"Anthracycline-induced cardiomyopathy in childhood cancer survivors is associated with gene signatures of mitochondrial dysfunction-a COG ALTE03N1 report.","authors":"Patrick J Trainor, Purnima Singh, Xuexia Wang, Noha Sharafeldin, Liting Zhou, Lindsey Hageman, Saro H Armenian, Jill P Ginsberg, Douglas S Hawkins, Frank G Keller, Melissa M Hudson, Joseph P Neglia, Wendy Landier, Smita Bhatia","doi":"10.1186/s40959-025-00391-w","DOIUrl":"https://doi.org/10.1186/s40959-025-00391-w","url":null,"abstract":"<p><strong>Background: </strong>Anthracycline-induced cardiomyopathy is a leading cause of morbidity and mortality in survivors of childhood cancer. The mitochondrion is a key mediator of the cytotoxic effects of anthracycline treatment and mitochondrial dysfunction is a hallmark of cardiomyopathy and heart failure. We sought to evaluate whether mitochondrial processes differ between anthracycline-exposed childhood cancer survivors who developed cardiomyopathy versus those who did not.</p><p><strong>Methods: </strong>Peripheral blood was collected from 40 childhood cancer survivors who developed cardiomyopathy (cases) and 64 matched survivors who did not (controls). From these samples, gene expression was determined by RNA-Sequencing. Following bioinformatic processing, differential gene expression at the mRNA-level between cases and controls was determined. Human MitoCarta3.0, was utilized to determine if genes involved in mitochondrial processes were enriched for differential expression, and to identify differentially regulated mitochondrial pathways at the mRNA-level.</p><p><strong>Results: </strong>900 genes were identified as differentially expressed at the mRNA-level. The odds of a gene being differentially expressed were 2.43 times greater if it encodes for a protein that localizes to the mitochondria. Mitochondrial processes that were enriched for differentially expressed genes at the mRNA-level included electron transport chain complexes; reactive oxygen species metabolism; apoptosis, mitophagy, and autophagy; mitochondrial ribosome; mitochondrial transport and chaperones; and heme synthesis and processing. Additionally, we observed that a measure of pro-apoptotic balance (BAX to BCL-2 gene expression at the mRNA-level) was highest in severe cardiomyopathy, intermediate in mild cardiomyopathy, and lowest in survivors without cardiomyopathy.</p><p><strong>Conclusions: </strong>We observed substantial evidence that the expression of genes involved in mitochondrial processes differs in childhood cancer survivors who develop cardiomyopathy versus those who do not.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"87"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An innovative hybrid imaging protocol for whole-body ¹⁸F-FDG-PET/MRI in cardio-oncology: a proof-of-concept study.","authors":"Yaqiong Zhou, Hua Lin, Chuan Huang, Yuanwei Xu, Yangjie Li, Chunchao Xia, Qing Zhang, Yuchi Han, Xiaohong Ou, Yucheng Chen","doi":"10.1186/s40959-025-00377-8","DOIUrl":"10.1186/s40959-025-00377-8","url":null,"abstract":"<p><strong>Background: </strong>Early identification of cardiac involvement in oncology patients is critical but challenging. To date, no validated protocol integrates dedicated cardiac magnetic resonance imaging (CMR) within routine whole-body (WB) ¹⁸F-FDG PET/MRI examinations.</p><p><strong>Objectives: </strong>This proof-of-concept study evaluated the feasibility and effectiveness of a novel hybrid imaging protocol combining CMR and WB ¹⁸F-FDG PET/MRI for oncology patients.</p><p><strong>Methods: </strong>Fifteen patients with suspected or confirmed multiple myeloma (MM) were enrolled. All participants scheduled for oncologic ¹⁸F-FDG PET/MRI underwent an integrated protocol incorporating dedicated CMR sequences prior to WB PET/MRI. The CMR sequences included cine imaging, native T1 and T2 mapping, and feature-tracking to assess cardiac structure, function, and tissue characteristics. Feasibility, safety, and the prevalence of clinically relevant cardiac abnormalities were evaluated.</p><p><strong>Results: </strong>The protocol was successfully completed in all participants without adverse events, enabling comprehensive cardiac and oncologic assessment within an average procedure time of 115 min (cumulative scanning time 65.5 ± 9.8 min). Clinically relevant cardiac abnormalities were identified in 4 patients (27%), including reduced left ventricular ejection fraction, concentric hypertrophy, and increased myocardial ¹⁸F-FDG uptake.</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility of a novel, time-efficient, integrated ¹⁸F-FDG PET/MRI protocol combining oncologic staging with comprehensive cardiac assessment in a single examination. This approach serves as an ideal strategy for cardio-oncology, bridging the gap between cancer treatment and cardiac care.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"86"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease and diagnosis of advanced prostate cancer.","authors":"Kevin T Nead, Allen M Haas, Jing Zhao, Ting Xiong, Chad Tang, Sharon H Giordan, Nicholas J Leeper","doi":"10.1186/s40959-025-00384-9","DOIUrl":"10.1186/s40959-025-00384-9","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) and cancer are the two leading causes of death in the US. Preclinical models support a direct effect of cardiovascular disease (CVD) on accelerated cancer growth and spread. Our objective is to test the hypothesis that individuals with prevalent CVD are at an increased risk of presenting with more advanced prostate cancer at diagnosis.</p><p><strong>Methods: </strong>We conducted a case-control study in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases from 2010-2019. The analysis was undertaken from October 2024 to February 2025. We included male individuals aged ≥ 67 years diagnosed with invasive prostate cancer with at least two healthcare interactions and evidence of PSA screening in the 3 to 24 months prior to cancer diagnosis. Our exposure of interest was CVD in the 3 to 24 months prior to cancer diagnosis. Our a priori hypothesis tested the odds of prevalent CVD in patients with localized (T1-2 and N0 and M0) versus advanced (T3-4 or N + or M +) prostate cancer at diagnosis.</p><p><strong>Results: </strong>Our analysis included 12,120 matched individuals, with median age 75 years (interquartile range 71-80), of which 88% were white, 8% were black, and 59% had prevalent CVD. Multivariable adjusted models demonstrated that individuals with advanced prostate cancer at diagnosis had a statistically significant 10% increased odds of prevalent CVD (OR, 1.10; 95% CI, 1.00-1.22; p = 0.047). This finding was strongest when examining individuals with regional or distant spread at diagnosis (N + or M + ; OR, 1.19; 95% CI, 1.05-1.34; p = 0.006). Further, individuals with Gleason score ≥ 8 disease at diagnosis, had an increased odds of prevalent CVD (OR, 1.07; 95% CI, 1.01-1.13; p = 0.020).</p><p><strong>Conclusion: </strong>We demonstrate an association between prevalent CVD and advanced prostate cancer at diagnosis. Our results may help guide patients regarding personalized screening decisions, given current guidelines recommending shared decision-making, and can be used to facilitate targeted screening approaches.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"85"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of coronary artery calcium deposit for cardiovascular events in patients treated with immune checkpoint inhibitors.","authors":"Moaad Slieman, Ophir Freund, Galit Aviram, Haim Shmilovich, Zach Rozenbaum, Moran Gvili Perelman, Lior Zornitzki, Dana Viskin, Anna Rozenfeld Hemed, Shafik Khoury, Ofer Havakuk, Yan Topilsky, Shmuel Banai, Joseph Carver, Michal Laufer-Perl","doi":"10.1186/s40959-025-00389-4","DOIUrl":"10.1186/s40959-025-00389-4","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have become the standard for treating various cancers. Nevertheless, their use may lead to significant cardiovascular immune-related adverse events (CV irAEs).</p><p><strong>Objectives: </strong>We aimed to assess whether pre-treatment coronary artery calcium (CAC) deposition predicts CV irAEs in patients treated with ICIs.</p><p><strong>Methods: </strong>A retrospective single-center cohort of patients treated with ICIs who performed pre-treatment chest computed tomography. A visual CAC assessment was categorized into Positive or Negative calcium deposits. Patients with pre-existing ischemic heart disease were excluded. The primary endpoint was the composite CV irAEs, including myocarditis, acute coronary syndrome, heart failure, and arrhythmias, and the secondary endpoint was all-cause mortality.</p><p><strong>Results: </strong>The cohort included 240 patients with a median age of 67 (IQR 59-73) years and 47% female. The most prevalent type of cancer was lung cancer (36%), and the prominent ICIs was pembrolizumab (54%). Patients with Positive CAC (38%) were predominantly male, with higher rates of cardiovascular comorbidities. The primary outcome occurred in 36 cases (15%) at a median of 94 (IQR 48-338) days from the first ICIs dose. The Positive CAC group observed a non-significant trend toward a higher hazard for CV irAEs (HR 1.66, 95% CI 0.86-3.21, p = 0.13), with no significant difference in all-cause mortality (HR 1.15, 95% CI 0.88-1.51, p = 0.30).</p><p><strong>Conclusion: </strong>Pre-treatment CAC deposition did not demonstrate an independent predictive role in assessing the risk of CV irAEs and all-cause mortality in patients treated with ICIs.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"84"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like peptide-1 receptor agonists in patients with anthracycline related cardiac dysfunction.","authors":"Isabel G Scalia, Ramzi Ibrahim, Mahmoud Abdelnabi, Hoang Nhat Pham, Juan M Farina, Milagros Pereyra Pietri, Kwan S Lee, Balaji K Tamarappoo, Reza Arsanjani, Chadi Ayoub","doi":"10.1186/s40959-025-00381-y","DOIUrl":"10.1186/s40959-025-00381-y","url":null,"abstract":"<p><strong>Background: </strong>Cancer therapy-related cardiac dysfunction (CTRCD) is recognized complication of antineoplastic therapies, and is particularly associated with anthracyclines. Treatment revolves around heart failure management, with limited evidence for other medications. Specifically, the aim of this study is to evaluate the role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with CTRCD.</p><p><strong>Methods: </strong>All adult cancer patients with a diagnosis of anthracycline induced CTRCD between 2012 and 2022 were retrieved from the TriNetX Research Network. Baseline characteristics, oncology data, and laboratory parameters were also abstracted. Patients were grouped based on administration of GLP-1RAs, with the development of a propensity matched non-GLP-1RA treatment cohort. Clinical outcomes were compared between the cohorts including all-cause mortality, all cause hospitalizations, acute heart failure events, acute renal failure, new atrial fibrillation, and cardiac arrest.</p><p><strong>Results: </strong>Overall, 2282 cancer patients with CTRCD were identified. Following propensity matching, a control cohort of 201 patients who did not receive GLP-1RAs were compared to 201 patients receiving GLP-1RAs. Over a mean follow-up of 295.4 ± 109.6 days, patients receiving GLP-1RAs treatment had significantly lower risk of all-cause hospitalization (HR 0.617, 95% CI 0.474-0.803, p < 0.001), acute heart failure events (HR 0.612, 95% CI 0.428-0.875, p = 0.007), and acute renal failure (HR 0.577, 95% CI 0.408-0.815, p = 0.002). There were no significant differences in the risk of all-cause mortality, atrial fibrillation, or cardiac arrest.</p><p><strong>Conclusion: </strong>In cancer patients with anthracycline induced CTRCD, those treated with GLP-1RAs had significantly lower risk of adverse clinical outcomes.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"83"},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular toxicity of Fruquintinib in patients with colorectal and other cancers: a systematic review and meta-analysis.","authors":"Ahmad Nouri, Ameer Awashra, Dawoud Hamdan, Islam Rajab, Abdalhakim Shubietah, Yahya Ismail, Anan Abu Rmilah","doi":"10.1186/s40959-025-00347-0","DOIUrl":"10.1186/s40959-025-00347-0","url":null,"abstract":"<p><strong>Background: </strong>Fruquintinib is a highly selective tyrosine kinase inhibitor that targets vascular endothelial growth factor receptors (VEGFR) 1, 2, and 3, which play a critical role in angiogenesis and tumor growth. As a novel anti-angiogenic agent, Fruquintinib has demonstrated promising efficacy in the treatment of various advanced malignancies, including metastatic colorectal cancer. However, concerns about its cardiovascular safety have emerged, given that VEGFR inhibition is often associated with cardiovascular adverse events.</p><p><strong>Methodology: </strong>We conducted a systematic search through PubMed, Scopus, Embase, and Web of Science to identify randomized controlled trials and cohort studies that assessed the safety of Fruquintinib compared with placebo in patients with metastatic colorectal and other cancers. The evaluated outcomes included hypertension, coronary artery disease, cerebrovascular accidents, peripheral artery disease, heart failure, thromboembolism, arrhythmias, aortic dissection, and superior vena cava syndrome. Two independent reviewers screened the titles/abstracts based on predefined inclusion and exclusion criteria, followed by a full-text review of potentially relevant studies. Any disagreements between the reviewers were resolved through consultation with a third reviewer to ensure the accuracy and consistency of the study selection.</p><p><strong>Results: </strong>Fifteen reports were included in our study. Out of 3832 patients taking Fruquintinib monotherapy, a total of 997 developed hypertension with a pooled estimate incidence of 0.329 (95% CI: 0.248, 0.410; P < 0.001). In comparison to placebo, Fruquintinib was associated with significantly higher odds of developing hypertension (OR: 6.856; 95% CI: 5.071, 9.268; P < 0.001). Compared to Regorafenib, Fruquintinib demonstrated an OR of 1.549 (95% CI: 0.804, 2.983; P = 0.191) for the development of hypertension. Additionally, patients taking Fruquintinib had a pooled estimate incidence of 0.041 (95% CI: 0.021, 0.060, P < 0.001) for thromboembolism development with an OR of 2.092 (95% CI: 0.813, 5.385; P = 0.126) compared to placebo. Other reported cardiovascular side effects included sinus tachycardia, superior vena cava syndrome, peripheral edema, heart failure, myocardial enzymes elevation, and vascular access complications.</p><p><strong>Conclusion: </strong>Our study found that Fruquintinib is associated with significant cardiovascular risks, with hypertension being the most common adverse event, while thromboembolism did not reach statistical significance. Therefore, close monitoring for treatment-related cardiovascular events should be considered in these patients.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"82"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a screening algorithm to detect cardiac amyloidosis in mild to severe aortic valve stenosis.","authors":"Fabian Voß, Elric Zweck, Jean Marc Haurand, Jafer Haschemi, Christian Jung, Tobias Zeus, Kathrin Klein, Ralf Westenfeld, Stephan Angendohr, Roland Fenk, Roman Pfister, Maximilian Spieker, Malte Kelm, Amin Polzin, Daniel Scheiber","doi":"10.1186/s40959-025-00383-w","DOIUrl":"10.1186/s40959-025-00383-w","url":null,"abstract":"<p><strong>Background: </strong>Cardiac Amyloidosis (CA) remains highly underdiagnosed, especially among patients with causes of increased ventricular wall thickness, such as aortic stenosis (AS). The prevalence of CA throughout the spectrum of mild to severe AS is unknown and specific validated diagnostic parameters for this population are lacking. Here, we propose and prospectively evaluate a screening algorithm for CA among patients with mild to severe AS.</p><p><strong>Methods: </strong>In this prospective, single-center study (NCT05010980), we included patients ≥ 65 years with mild to severe AS, an interventricular septum thickness > 11 mm, and at least one of the following criteria: Sokolow-Lyon-Index to left ventricular mass index ratio < 1.6 or stroke volume index < 35 ml/m2. Participants were prospectively screened for CA according to current guideline recommendations.</p><p><strong>Results: </strong>After screening 2126 patients of whom 187 were eligible, 57 participants were enrolled and completed the diagnostic work-up. Mean age was 83 ± 0.7 years and 71% were male. 30% of the participants had mild, 37% had moderate and 33% had severe AS, respectively. Overall 26% of participants were diagnosed with CA. The prevalence of CA was higher among patients with mild AS (41%) compared to participants with moderate (24%) or severe AS (16%, p = 0.01). Within this preselected patient population, troponin (AUC:0.9, p < 0.0001) and NT-proBNP (AUC:0.86, p < 0.0001) further improved discrimination of patients with and without CA.</p><p><strong>Conclusion: </strong>The prevalence of CA among AS patients fulfilling the preselected inclusion criteria was high, especially among those with mild to moderate AS. Implementing these criteria in clinical protocols could improve early diagnosis of CA.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"81"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant carcinoid heart disease and patent foramen ovale: a case report and review of literature.","authors":"Nuno Cotrim, Ricardo Carvalheiro, Bárbara Teixeira, Tânia Mano, Lídia de Sousa, Mariana Saraiva, Vítor Martins","doi":"10.1186/s40959-025-00380-z","DOIUrl":"10.1186/s40959-025-00380-z","url":null,"abstract":"<p><strong>Background: </strong>Carcinoid Heart Disease (CHD) primarily affects the right heart valves, while left heart involvement is rare and often associated with a patent foramen ovale (PFO). Early identification of a PFO in CHD can be critical to patient outcomes. A 61-year-old woman with metastatic neuroendocrine tumor presented with worsening breathlessness and hypoxemia. Imaging excluded pulmonary embolism and lung metastases. Transthoracic echocardiography revealed severe tricuspid regurgitation due to carcinoid valve involvement. Persistent hypoxemia prompted transesophageal echocardiography, which demonstrated a right-to-left shunt through a PFO. Right heart catheterization confirmed the findings excluding significant pulmonary hypertension. Percutaneous PFO closure improved oxygenation, but the patient deteriorated due to right ventricular failure and ultimately died from multiorgan failure despite later tricuspid valve replacement.</p><p><strong>Conclusion: </strong>This case illustrates the importance of early detection of PFO in CHD, as delayed intervention can lead to poor outcomes. Simultaneous PFO closure and valve replacement may be preferable to a staged approach. A multidisciplinary strategy is vital for timely diagnosis and optimal treatment planning in such complex cases.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"80"},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2i Dapagliflozin in primary prevention of chemotherapy induced cardiotoxicity in breast cancer patients treated with neo-adjuvant anthracycline-based chemotherapy +/- trastuzumab: rationale and design of the multicenter PROTECT trial.","authors":"A Greco, V Quagliariello, G Rizzo, A Tedeschi, S Schirinzi, A Turco, M Galiazzo, M Acquaro, M De Amicis, C Klersy, S Ghio, L Perrone, A Paccone, G Uccello, M L Canale, S Oliva, F Guerra, L De Luca, N Maurea, L Scelsi","doi":"10.1186/s40959-025-00368-9","DOIUrl":"10.1186/s40959-025-00368-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;SGLT2i exerts several cardiometabolic benefits in heart failure with reduced and preserved ejection fraction through the systemic reduction of insulin, visceral fat, chemokines and growth factors involved in cardiovascular diseases. Anthracyclines are considered the principal culprit drugs behind chemotherapy-induced cardiotoxicity. The pathognomonic manifestation of anthracycline-induced cardiotoxicity is a hypokinetic cardiomyopathy progressively leading to heart failure. Anthracycline-induced cardiotoxicity is still a significant problem that compromises the quality of life and overall survival of breast cancer (BC) patients. Sequential therapy regimen of anthracyclines and HER-2 blocking agents is associated to higher risk of cardiotoxicity compared to monotherapy regimen. Recent studies in preclinical models of anthracycline-induced cardiotoxicity concluded that SGLT2i are able to prevent ejection fraction reduction and myocardial inflammation and fibrosis. A very recent retrospective study indicates that SGLT2i were associated with lower rate of cardiac events among patients with cancer and T2DM who were treated with anthracyclines. These data support the conducting of a randomized clinical trial testing Dapagliflozin in patients with breast cancer treated with anthracyclines+/- trastuzumab.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the cardioprotective effects of the SGLT2 inhibitor Dapagliflozin in chemotherapy-naive patients with stage I-III breast cancer undergoing anthracycline-based treatment with or without trastuzumab, by assessing its ability to reduce the incidence of cardiotoxicity and improve systemic cardiometabolic markers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Chemotherapy-naive patients (18-70 years) scheduled for antracycline +/- trastuzumab treatment in the [neo-]adjuvant setting for stage I-III breast cancer, will be randomized using a web-based system stratified by the use of trastuzumab to follow a chemotherapy regimen plus Dapagliflozin [10 mg/die] [active group] or chemotherapy regimen plus standard of care [control group]. During follow up period, if a patient develops asymptomatic or symptomatic systolic disfunction will be treated according to good clinical practice. From randomization, to the third, sixth, twelfth and eighteenth months, echocardiographic and cardiological visits will be performed associated to blood analysis for quantification of cardiotoxicity biomarkers (NT-pro-BNP, hsTNI), CKD-EPI eGFR and systemic inflammation (hsCRP, chemokines, cytokines and growth factors).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study is ongoing. Results will be published when the study is completed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The PROTECT trial is the first randomized clinical study designed to evaluate whether Dapagliflozin can reduce anthracycline- and/or trastuzumab-associated cardiotoxicity in patients with early-stage breast cancer. Beyond its established cardiometabolic effects, this","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"79"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strain-derived myocardial work indices in adult cancer survivors: results from an observational study and comparison with available reference ranges.","authors":"Massimiliano Camilli, Federico Ballacci, Priscilla Lamendola, Marcello Viscovo, Giulia Tamburrini, Lorenzo Tinti, Ilaria Torre, Ludovica Amore, Stefan Hohaus, Filippo Crea, Gaetano Antonio Lanza, Francesco Burzotta, Giorgio Minotti, Antonella Lombardo","doi":"10.1186/s40959-025-00373-y","DOIUrl":"10.1186/s40959-025-00373-y","url":null,"abstract":"<p><strong>Aims: </strong>Adult survivors of haematological malignancies are at increased risk of long-term cardiovascular sequelae. Several echocardiographic metrics have been tested to detect subclinical myocardial dysfunction before it progresses toward cardiac events. Myocardial work (MW) is a load-independent echocardiographic index that conjugates non-invasive arterial blood pressure and global longitudinal strain (GLS).</p><p><strong>Methods: </strong>Sixty-three disease-free survivors of Hodgkin Lymphoma (HL) [49% male, median age 42 (33,0-50,5) years], without known cardiovascular disease or reported cardiological symptoms, were included in this observational study. Myocardial work data from cancer survivors were compared with those from healthy subjects recruited in the EACVI NORRE Study.</p><p><strong>Results: </strong>Mean left ventricular ejection fraction and GLS were, respectively, 57,0% (55,0-60,0) and - 18,0% (-19,2-17,1). Global work efficiency [GWE, 96% (94-97)], global work index (GWI, 1732 ± 340 mmHg%) and global wasted work [GWW, 78 (55-131) mmHg%] did not differ between male and female survivors; however, global constructive work (GCW, 2116 ± 386 mmHg%) was lower in males. Of importance, GWI and GCW were lower in cancer survivors compared to healthy subjects from the EACVI NORRE study (p = 0,0008 and p = 0,0324, respectively). When evaluating associations of MW indices with patients' characteristics, only systolic blood pressure and ejection fraction were independently associated with both GWI and GCW at multivariable analysis.</p><p><strong>Conclusion: </strong>For the first time, this report provides values of MW indices in asymptomatic HL survivors without cardiovascular disease. GWI and GCW were significantly lower in HL survivors compared to healthy subjects. MW metrics might serve as valuable markers of subclinical cardiac dysfunction in this population.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"78"},"PeriodicalIF":3.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}