Cardio-oncology最新文献

{"title":"Predicting immune checkpoint inhibitor cardiotoxicity using machine learning: a systematic review of model performance and methodological quality.","authors":"Vaibhav Roy","doi":"10.1186/s40959-026-00505-y","DOIUrl":"10.1186/s40959-026-00505-y","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) significantly improve cancer outcomes but can cause rare, potentially fatal cardiotoxicity, including myocarditis and major adverse cardiovascular events (MACE). Machine learning (ML) and artificial intelligence (AI) models have emerged as promising tools for early detection and risk prediction; however, their performance, methodological quality, and clinical applicability remain unclear.</p><p><strong>Objective: </strong>To systematically evaluate ML-based prediction models developed to identify cardiotoxicity, myocarditis, or cardiac adverse events in patients receiving ICIs, and assess their methodological robustness using PROBAST.</p><p><strong>Methods: </strong>A systematic search of PubMed (18-20 November 2025) was performed using a multi-stage strategy (broad → refined → high-specificity). Seven studies met eligibility criteria. Data extraction covered population, predictors, outcomes, model types, validation, and performance metrics. Risk of bias was assessed using PROBAST. Supplementary files include full search strategies, extraction sheets, PRISMA flow diagram, and PROBAST tables.</p><p><strong>Results: </strong>Seven ML models were identified, including XGBoost, multimodal deep learning, neural networks, ECG-based AI models, pharmacovigilance-driven ML, and two clinical nomograms. Sample sizes ranged from 23 to 4,282 patients. Reported AUC values varied: XGBoost, 0.92; Fusion AI, 0.88; FAERS ML, 0.83; ECG AI, 0.91; Time-series NN, predictive ranking only; Nomogram, 0.83-0.967. Troponin, ECG features, neutrophil-lymphocyte ratio, NT-proBNP, and clinical factors such as steroid dose and radiotherapy emerged as consistent predictors. PROBAST identified high risk of bias in three models (mainly due to small datasets, inadequate validation, and unclear handling of missing data). Two studies using independent validation cohorts achieved low risk of bias.</p><p><strong>Conclusion: </strong>ML-based models show promising discriminative ability for predicting ICI-related cardiotoxicity and myocarditis; however, most studies suffer from methodological limitations that restrict real-world clinical adoption. Larger multicenter cohorts, standardized definitions, multimodal integration, and adherence to TRIPOD-AI reporting guidelines are needed to advance clinically deployable models.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013714","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":"Correction: CPX-351 vs. conventional chemotherapy cardiotoxicity in high-risk AML: a post hoc phase III trial analysis.","authors":"Joshua D Mitchell, Michael Pfeiffer, John Boehmer, John Gorcsan, Shunsuke Eguchi, Yoshiyuki Orihara, Nalina Dronamraju, Sonja Dhani, Stefan Faderl, Tara L Lin, Geoffrey L Uy, Jeffrey E Lancet, Jorge E Cortes","doi":"10.1186/s40959-026-00502-1","DOIUrl":"10.1186/s40959-026-00502-1","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004861","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":"Left-sided mastectomy mimics LVEF decline on CZT-ERNA: a consideration for cardio-oncology practice.","authors":"Maiken Engel Fiala, Lars Thorbjørn Jensen, Bo Zerahn, Marc Østergaard Nielsen","doi":"10.1186/s40959-026-00508-9","DOIUrl":"10.1186/s40959-026-00508-9","url":null,"abstract":"<p><strong>Background: </strong>Monitoring of left ventricular ejection fraction (LVEF) is essential in patients receiving potentially cardiotoxic cancer therapies. Equilibrium radionuclide angiography (ERNA) remains an established method for quantitative assessment of LVEF. However, the absence of attenuation correction may render the method sensitive to anatomical changes, such as those caused by mastectomy. The aim with this study was to investigate whether left-sided mastectomy systematically affects the estimation of LVEF using cadmium-zinc-telluride (CZT)-based ERNA.</p><p><strong>Methods: </strong>This retrospective single-centre cohort study included breast cancer patients who had undergone unilateral or bilateral mastectomy and had both pre- and postoperative CZT-ERNA performed under identical acquisition protocols. Pre- to postoperative changes in LVEF, left ventricular end-diastolic volume (LVEDV), and left ventricular end-systolic volume (LVESV) were compared between left- and right-sided mastectomy groups.</p><p><strong>Results: </strong>Between-group comparison showed that left-sided mastectomy (including bilateral) was associated with a significant decrease in LVEF (mean change -4.0 percentage points, 95% CI -6.0 to -2.0, p = 0.011). In contrast, no significant within-group change was observed for right-sided mastectomy (mean change 0.6 percentage points, 95% CI -2.4 to 3.6, p = 0.7). One in four patients (25%) in the left-sided group experienced a decline in LVEF of at least 10 percentage points, compared with 1 in 17 in the right-sided group. Multivariable regression analysis indicated that LVEF decline was independently associated with mastectomy laterality, whereas cumulative anthracycline dose and radiotherapy were non-significant.</p><p><strong>Conclusion: </strong>Left-sided mastectomy is associated with a significant decrease in LVEF measured by CZT-ERNA. This finding likely reflects improved delineation of LVESV rather than true systolic decline. Recent chest surgery and individual anatomical changes should be considered when interpreting serial CZT-ERNA examinations. Confirmatory imaging may be warranted in cases of unexpected or pronounced LVEF declines.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004784","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":"Trends in cardiovascular mortality among lung cancer patients in the United States: a retrospective study from 1999 to 2023.","authors":"Yong-Li Chen, Jian-Quan Chen, Lin-Wen Zeng, Jin-Yan Wu, Xiao-Xia Qiu, Zhen-Nan Lin, Jie Xiao, Xing Miao, Re-Hua Wang, Jian-Cheng Zhang","doi":"10.1186/s40959-026-00512-z","DOIUrl":"10.1186/s40959-026-00512-z","url":null,"abstract":"<p><strong>Background: </strong>Although cardiovascular disease (CVD) frequently co-occurs with lung cancer and adversely affects prognosis, the temporal patterns of CVD mortality in this patient group remain inadequately explored. We aimed to clarify trends and disparities in CVD mortality among United States (US) adults with lung cancer.</p><p><strong>Methods: </strong>Utilizing the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) spanning from 1999 to 2023 for adults aged 35 years and older, we calculated age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 individuals, with the AAMRs standardized to the 2000 US population. The annual percent change (APC) and average annual percent change (AAPC) were estimated using joinpoint regression analysis. In CDC WONDER, the National Center for Health Statistics assigns the underlying cause of death using standardized World Health Organization rules. Thus, we defined CVD as the underlying cause of death and lung cancer as a contributing cause based on the database's coding framework rather than investigator judgment.</p><p><strong>Results: </strong>Among 93,859 CVD deaths in lung cancer patients, mortality declined significantly from 1999 to 2015 (APC: - 4.70), but increased in females from 2015 to 2023 (APC: 1.73), while remaining stable in males (APC: 0.44). Males experienced a more pronounced reduction in AAMRs, decreasing from 5.39 in 1999 to 2.24 in 2023, but consistently had higher CVD mortality rates than females. During most of the study period, Non-Hispanic African American or Black (NH Black) individuals experienced the highest AAMRs, followed by NH Whites. Long-term decline in CVD mortality reversed significantly among individuals aged ≥ 85 years since 2017. Significant differences in AAPC relative to the general population were identified among the Northeast, NH Black, NH White, males, and across all age groups except for the 75-84 cohort.</p><p><strong>Conclusions: </strong>Although CVD mortality in the US declined from 1999 to 2023, this trend has stalled or reversed among adults with lung cancer since 2015. Ongoing disparities by sex, race, age, region, and state emphasize the urgent need for targeted interventions for these vulnerable groups.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004868","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":"Rapid symptomatic and metabolic response to emergency radiotherapy in a critically ill patient with primary cardiac lymphoma: a multidisciplinary case report.","authors":"Chengqi Yu, Weiping Liu, Huiming Yu","doi":"10.1186/s40959-026-00509-8","DOIUrl":"10.1186/s40959-026-00509-8","url":null,"abstract":"<p><p>Primary cardiac lymphoma (PCL), an exceptionally rare and aggressive malignancy with median survival under one month, often presents with contraindications to first-line chemotherapy in critically ill patients. We report a 66-year-old woman with acute heart failure, pulmonary embolism, and ECOG performance status 4, diagnosed with right atrial diffuse large B-cell lymphoma (76 × 75 mm, SUVmax = 29.1). Due to chemotherapy contraindications, emergency radiotherapy (18 Gy/10 fractions) was initiated. Within five fractions, significant symptomatic improvement occurred with resolution of dyspnea and edema, accompanied by improved oxygenation (SpO₂ 86%→95%) and ECOG status (4→3). Post-treatment PET/CT demonstrated a profound metabolic response (SUVmax = 2.9-3.6), enabling successful transition to systemic chemotherapy. This case underscores emergency radiotherapy as an effective bridge therapy for critically ill PCL patients, facilitated by multidisciplinary coordination.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986835","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":"Impact of echocardiographic hemodynamics on outcomes among patients with polycythemia vera or essential thrombocythemia.","authors":"Orly Leiva, Steven Soo, Olivia C Liu, Victor You, Gabriela Hobbs","doi":"10.1186/s40959-026-00510-1","DOIUrl":"10.1186/s40959-026-00510-1","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary hypertension (PH) and high-output heart failure (HOHF) are associated with myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET) and polycythemia vera (PV). Transthoracic echocardiography (TTE) is a non-invasive modality that can be used for the screening of PH and HOHF. However, the impact of echocardiographic HOHF on TTE on outcomes of patients with ET or PV is unclear.</p><p><strong>Methods: </strong>This was a multicenter, retrospective cohort study of patients with ET or PV with ≥ 1 TTE. Estimated pulmonary artery systolic pressure (PASP) and cardiac index were calculated using doppler TTE. Patients were categorized based on TTE hemodynamics as echocardiographic HOHF (PASP > 40 mmHg and cardiac index > 3.54 L/min/m2), elevated PASP alone, elevated cardiac index alone, and normal PASP and cardiac index. Primary outcome was all-caused death or MPN disease progression.</p><p><strong>Results: </strong>A total of 272 patients (150 PV, 122 ET) were included, 16 (5.9%) with echocardiographic HOHF, 31 (11.4%) elevated cardiac index alone, 63 (23.2%) elevated PASP alone, and 147 (54.0%) with normal hemodynamics. After multivariable Cox proportional hazards regression, echocardiographic HOHF (adjusted HR 3.35, 95% CI 1.53-7.34) and elevated PASP alone (adjusted HR 2.89, 95% CI 1.70-4.92) were associated with increased of primary outcome. Increased risk of HF hospitalizations was seen across all abnormal hemodynamic vs. normal hemodynamics.</p><p><strong>Conclusions: </strong>Among patients with ET or PV, echocardiographic HOHF and elevated PASP alone were associated with increased risk of death or MPN disease progression. Prospective studies are needed to identify patients at risk of HOHF and PH.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13362223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980728","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":"Cardio-oncology research prioritisation in the United Kingdom: national surveys of health care professionals, patients and carers.","authors":"Gerard M Walls, Allyson Arnold, David Austin, Alison R Fielding, Simon P Fisher, Christopher A Miller, Charlotte Manisty, Anna Olsson-Brown, Mark C Petrie, John A Snowden, Nick Hartshorne-Evans, Keith Wilson, Vasilena Zhecheva, Ninian N Lang","doi":"10.1186/s40959-026-00503-0","DOIUrl":"10.1186/s40959-026-00503-0","url":null,"abstract":"<p><strong>Background: </strong>The relevance of cardiovascular disease in people with a history of cancer has increased in parallel with dramatic improvements in cancer-specific outcomes. There is an urgent need to improve the evidence underpinning cardio-oncology practice. Research prioritisation is essential and needs to account for multidisciplinary healthcare professional (HCP) perspectives, as well as patients and carers.</p><p><strong>Methods: </strong>The NIHR-BHF Cardiovascular Partnership Theme in Cardio-Oncology conducted two UK-wide online surveys to identify research priorities. The first was distributed to HCPs with cardiology, oncology and haemato-oncology backgrounds. The second was distributed to patients and carers (PCs) with experience of cancer and/or cardiovascular disease. Surveys were co-designed by clinicians and patients.</p><p><strong>Results: </strong>HCP Survey: 127 responded; 53% prioritised research 'during cancer treatment'. Immune checkpoint inhibitors and targeted therapies were identified as the highest-priority drug classes. Cardiac dysfunction/heart failure (53%) and myocarditis (22%) were priority cardiovascular toxicities of interest. The development of a cardio-oncology registry was marginally favoured over randomised trials. Prospective randomised open-label blinded endpoints (PROBE) designs were considered of similar priority to double-blinded placebo controlled trials. PC Survey: 267 responded. 54% were concerned about the impact of cancer treatment upon cardiovascular health. PC research priorities were: prevention of cardiac side effects (58%), long-term cardiac monitoring, and early detection of side effects. Willingness to participate in research was high.</p><p><strong>Conclusion: </strong>HCPs and PCs from the UK prioritised prevention and detection of cardiac dysfunction during and immediately following cancer therapy, particularly with agents such as immune checkpoint inhibitors and targeted therapies. These findings provide important strategy-setting insights for large-scale collaborative cardio-oncology studies.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13359712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970747","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":"Inflammation mediates platinum-based chemotherapy-induced risk of adverse cardiac events in older NSCLC patients: a pilot study.","authors":"Guoxing Zhang, Chao Liu, Xueying Zhang, Chunyi Jia, Baosheng Sun, Yongjie Wang, Jiming Xu, Linfeng Li, Haifeng Liu","doi":"10.1186/s40959-026-00511-0","DOIUrl":"10.1186/s40959-026-00511-0","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy increases the risk of cardiovascular toxicity, leading to adverse cardiac events (ACEs) in cancer patients. However, the underlying mechanisms and roles of mediators in this association remain poorly understood.</p><p><strong>Objectives: </strong>This study aimed to investigate the mediating role of inflammation in the association between platinum-based chemotherapy (PBC) and increased risk of ACEs in older patients with non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>We retrospectively analyzed data from NSCLC patients aged ≥ 50 years, initially diagnosed between 2018 and 2020 at our institution. The treatment group included patients who received PBC, whereas the control group consisted of patients who did not. The mediator was the maximum neutrophil-to-lymphocyte ratio (NLR) measured between initial chemotherapy and one year after diagnosis. The outcome was the occurrence of ACEs during follow-up period. Causal mediation analysis was conducted to assess the mediating effect of a clinically meaningful inflammatory response on the PBC-ACE association.</p><p><strong>Results: </strong>Among the 1,450 patients included (55% male, 45% female; median age: 61.6 years), 242 (16.7%) developed ACEs during the follow-up. The average direct effect was similar across both groups (control: 0.050, p = 0.018; treatment: 0.052, p = 0.018), indicating the consistent direct impact of PBC on the occurrence of ACE. However, the proportion of the total effect mediated by inflammation was higher in the treatment group (11.83%, p = 0.01) than that in the control group (9.12%, p = 0.01). Additionally, the average causal mediation effect was greater in the treatment group (0.0067, p < 0.01) than in the control group (0.0052, p < 0.001).</p><p><strong>Conclusions: </strong>Inflammation plays a crucial role in mediating the association between PBC and increased risk of ACEs in older patients with NSCLC. The mediating effect was more prominent in patients receiving PBC, emphasizing the need to monitor and manage inflammation to mitigate cardiovascular risks in patients with NSCLC undergoing PBC.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980731","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":"From data to decision: a clinical pipeline for wearable AI in early cardiotoxicity detection.","authors":"Ziqiang Zhou, Jinwen Wang","doi":"10.1186/s40959-026-00506-x","DOIUrl":"10.1186/s40959-026-00506-x","url":null,"abstract":"<p><p>Chemotherapy-induced cardiotoxicity (CIC) is a leading cause of morbidity in cancer survivors, as conventional surveillance often detects cardiac dysfunction only after significant injury. This review moves beyond summarizing emerging technologies to focus on the end-to-end clinical pipeline-from sensor data to actionable decision-making-for creating a proactive \"early-warning\" system. We examine how continuous monitoring with wearable devices and artificial intelligence (AI) can detect subclinical CIC by analyzing digital biomarkers like heart rate variability. Proof-of-concept studies show AI can predict LVEF decline with moderate to high accuracy, though evidence is limited by small cohorts and lacks external validation. Implementing this wearable-AI pipeline could fill a critical surveillance gap and enable timely cardioprotective interventions. However, large-scale validation and building clinician trust through interpretable models are crucial before routine clinical adoption.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970768","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":"SWATH-MS for discovery of early biomarkers of drug-induced cardiotoxicity using an animal doxorubicin model.","authors":"Rohan Shotton, Amy Campbell, Ivona Baricevic-Jones, Rachel Reed, Janet Kelsall, Joanna Williams, Howard Mellor, Richard D Unwin, Kim Linton","doi":"10.1186/s40959-026-00484-0","DOIUrl":"10.1186/s40959-026-00484-0","url":null,"abstract":"<p><strong>Background: </strong>Clinical use of anthracyclines is limited by cumulative dose-dependent cardiotoxicity, though the mechanisms responsible for this are complex and incompletely understood. Existing biomarkers of anthracycline-related cardiotoxicity, such as troponin and NT-proBNP, lack sensitivity for the earliest stages of cardiotoxicity, therefore limiting scope to switch to alternative, safer treatment. As such, a reliable early biomarker of anthracycline-related cardiotoxicity remains a key unmet research need.</p><p><strong>Methods: </strong>We investigated the rat myocardial proteome to identify novel biomarkers of anthracycline-related cardiotoxicity warranting further investigation for routine clinical application. Six groups of 8 Han-Wistar rats were dosed weekly for 1-7 doses with either doxorubicin 1.25 mg/kg or saline control, followed by terminal bleeds. Sequential window acquisition of all theoretical mass spectra (SWATH-MS) was used to compare the rat myocardial proteome at serial timepoints and between doxorubicin- and saline-treated animals. A shortlist of candidate biomarkers was generated by identifying proteins with significant log₂ fold changes at early/mid timepoint dysregulation, sustained to later timepoints. Pathway analysis for human ortholog proteins was undertaken using the Uniprot database and STRING.</p><p><strong>Results: </strong>Three proteins were differentially expressed at early, mid- and late timepoints (myosin light chain 3, desmin and cysteine-rich protein 2). A further 10 proteins were differentially expressed at mid- and late timepoints. Pathway analysis identified biological processes enriched within the myocardial proteome, predominantly related to muscle, metal ion, haemostasis, lipid and inflammation processes. A candidate biomarker shortlist of 34 proteins was derived for future study.</p><p><strong>Conclusion: </strong>We used a rat anthracycline dosing schedule to recapitulate the development of cardiotoxicity observed in humans. We describe a shortlist of 34 proteins with promise as candidate biomarkers of the earliest stages of anthracycline-related cardiotoxicity and summarise pathway analysis of functionally enriched biological processes within the rat myocardial proteome during anthracycline treatment. Further study is underway to explore these shortlisted proteins in rat plasma, with a human study planned to validate best-performing biomarkers.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927069","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}