Cardio-oncology最新文献

{"title":"Clinical added value of triplicate electrocardiograms: a review of 505 triplicate sets.","authors":"Michael S Ewer, Hyeon-Ju Ryo Ali, Nicolas L Palaskas, Jay Herson, Anita Deswal","doi":"10.1186/s40959-026-00472-4","DOIUrl":"10.1186/s40959-026-00472-4","url":null,"abstract":"<p><p>Triplicate electrocardiograms (ECGs) are routinely included in clinical trials where concern of agent-induced electrophysiological alterations arise. Three electrocardiograms (triplicate ECGs) are obtained over a time interval of less than 10 min with the intent to increase recognition of changes, and to provide increased data for measurement and review of physiologic intervals. We undertook a prospective review of over 500 sets of triplicate ECGs to evaluate the added value of two additional tracings over a single ECG. Our review was done exclusively to evaluate the actual ECG tracings and not the reproducibility of the electronic interpretive algorithms. All ECGs were reviewed by one of the cardiologists over a four-month period. We found no meaningful changes in R-R, P-R, or Q-T intervals, nor any change in the QRS duration that was observed during the ≤ 10-minute period of data acquisition; rare supraventricular and ventricular ectopy was noted in 4 of the 505 triplicate sets. The routine inclusion of a requirement for triplicate ECGs should be revaluated to assess the added value to the patient or clinical research as well as potential burdens to the patient and financial impact.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479890","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":"Echocardiographic high-output heart failure is associated with worse survival among patients with myelofibrosis.","authors":"Orly Leiva, Steven Soo, Olivia C Liu, Victor You, Andrew Palmer, Justin Kahla, Yasmeen Murtaza, Olatoyosi Odenike, Anand Patel, Jeanne DeCara, Mark Belkin, Manreet Kanwar, Leo Gozdecki, Stanley Swat, Michelle Hyunju Lee, Joan How, Gabriela Hobbs","doi":"10.1186/s40959-026-00468-0","DOIUrl":"10.1186/s40959-026-00468-0","url":null,"abstract":"<p><p>INTRODUCTION: Myelofibrosis (MF) is a type of myeloproliferative neoplasm (MPN) that is associated with significant morbidity and mortality including progression to acute leukemia and cardiovascular disease (CVD). High-output heart failure (HOHF) has been previously associated with MF, though its impact on outcomes is unknown. AIMS: To investigate the impact of HOHF on outcomes among patients with MF. METHODS AND RESULTS: This was a multicenter retrospective cohort study of MF patients from 2010-2024 with ≥ 1 transthoracic echocardiogram (TTE). Doppler estimation of cardiac index on TTE and pulmonary artery systolic pressure (PASP) was estimated and HOHF was defined as cardiac index of ≥ 3.54 L/min/m2 and PASP > 40 mmHg. Patients with vs without HOHF were compared. Primary outcome was death or leukemia transformation. Multivariable Cox proportional hazards regression was performed to explore association between HOHF and primary outcome. Of 114 patients included, 19 (16.7%) had HOHF, 46 (40.4%) were female. Patients with HOHF were more likely to have secondary MF and lower hemoglobin levels. After Cox proportional hazards regression modeling, HOHF was associated with increased risk of primary outcome (aHR 2.86, 95% confidence interval 1.01 – 8.09). CONCLUSIONS: Among patients with MF, HOHF was associated with increased risk of death or leukemia progression. These findings suggest that echocardiographic evaluation of patients with MF for HOHF may aid in the identification of patients at risk of hematologic progression or poor outcomes, in addition to traditional risk factors. Prospective studies are needed to investigate the utility of echocardiographic screening for patients with MF. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431141","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":"Pharmacogenomic predictors of anthracycline-induced cardiotoxicity in breast cancer patients: a systematic review and meta-analysis.","authors":"Vani Mahathi Bulusu, Bhushan Shah, Sheela Sawant, Akansha Choudhary, Saikat Das, Suruchi Jain, Surulivel Rajan Mallayasamy, Karthik S Udupa, Neha Arya, Jitendra Singh, Mahadev Rao, Rupinder Kaur Kanwar, Amit Kumar, Murali Munisamy","doi":"10.1186/s40959-026-00449-3","DOIUrl":"10.1186/s40959-026-00449-3","url":null,"abstract":"<p><p>BACKGROUND: Anthracyclines significantly improve overall survival and play a vital role in the treatment of breast cancer. However, they are associated with cardiac dysfunction, which is often irreversible. Although anthracycline-induced cardiotoxicity (AIC) is dose-dependent, the difference in susceptibility patterns suggests the role of pharmacogenomics. Several studies explored the role of genetic variants in AIC. Integrating pharmacogenomic testing with routine anthracycline surveillance will help to predict the individuals who are at risk of developing AIC. Therefore, this current systematic review aims to evaluate and synthesize the evidence on the pharmacogenomics association of cardiotoxicity in individuals receiving anthracyclines for breast cancer treatment. METHODS: PubMed, Embase, and Scopus databases are systematically searched for the literature. After the initial search, 842 records have been identified. Following screening, 18 studies investigating genetic associations with AIC in breast cancer patients were found to be eligible for inclusion in the study. The quality of studies is assessed with the Q-Genie tool. The data is extracted and summarized with odds ratios and corresponding confidence intervals were reported. RESULTS: A total of 18 candidate gene association studies involving 4,703 breast cancer patients were included in the qualitative synthesis. Out of 57 genetic variants reported, 18 genetic variants (31.5%) are associated with an increased risk, while 3 genetic variants (5.3%) have demonstrated a risk-reducing tendency. DISCUSSION: Characterizing genetic variants in biological pathways of anthracyclines could inform precision therapy and the development of targeted interventions. The limitations of the synthesized evidence include the inadequate sample size, methodological bias within the included studies, inconsistent findings from different studies, and imprecise effect estimates. CONCLUSION: The genetic variants influence susceptibility to AIC in breast cancer patients. Further large-scale studies with longer follow-up are warranted to validate these associations and facilitate their translation into clinical practice. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347856","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 ventricular function and its longitudinal change in Swiss childhood cancer survivors - results from the CardioOnco study.","authors":"Severin Fankhauser, Yara Shoman, Fabiën N Belle, Eva Haegler-Laube, Moritz J Hundertmark, Gabriela M Kuster, Eva Scheler, Tomáš Sláma, Nicolas von der Weid, Claudia E Kuehni, Reto D Kurmann, Christina Schindera","doi":"10.1186/s40959-026-00463-5","DOIUrl":"10.1186/s40959-026-00463-5","url":null,"abstract":"<p><p>BACKGROUND/PURPOSE: Childhood cancer survivors (CCS) are at risk for cardiac late effects. Echocardiographic assessment of cardiac function by left ventricular ejection fraction (LVEF) is recommended for survivors treated with known cardiotoxic treatments (anthracyclines; heart-relevant radiotherapy). The evidence on cardiotoxicity of other systemic anticancer therapies is conflicting and longitudinal changes in heart function are understudied. We assessed cardiac function in CCS; factors associated with LVEF and longitudinal changes in LVEF. METHODS: In this ongoing prospective, multicenter cohort study, we invited CCS aged ≥ 18 years, diagnosed < 21 years, survived ≥ 5 years, and received any systemic anticancer therapy or heart-relevant radiotherapy between 1976 and 2019. We invited them for an echocardiographic assessment including 2-dimensional LVEF (reduced LVEF: <54% for females; <52% for males). We stratified CCS in anthracyclines only, heart-relevant radiotherapy only, both, and a standard risk group exposed to any other systemic anticancer treatment and compared groups using ANOVA- and t-tests. We performed multivariable linear regression to investigate sociodemographic, treatment-, and lifestyle-related factors (hypertension, smoking, dyslipidemia, diabetes, overweight/obesity), and multilevel modelling to assess LVEF changes over time. RESULTS: We assessed 487 CCS (median age: 32 years, IQR: 24–39) with a median time since diagnosis of 24 years (IQR 17‒31). Overall prevalence of reduced LVEF was 7.2% (35/487), 7.3% (19/260) for anthracyclines only, 3.6% (1/28) for heart-relevant radiotherapy only, 9.4% (8/85) for both, and 6.1% (7/114) for the standard risk group. Male CCS were at risk for reduced LVEF [β coefficient for male sex = -1.37; 95%CI -2.36, -0.37], and higher cumulative anthracycline dose (per 100 mg/m²) was associated with reduced LVEF (β − 0.83; 95%CI − 1.20, − 0.45). Heart-relevant radiotherapy, other systemic anticancer treatments, and lifestyle were not associated with LVEF. We found a slight annual improvement of LVEF 0.24% among 140 participants followed up for a median of 4.3 years, however, there was no indication of statistical significance (p = 0.12). CONCLUSION: This first Swiss study found that a substantial proportion of survivors had reduced LVEF, especially males and those treated with anthracyclines. While cardiac function appeared stable over a four-year period, long-term changes remain uncertain, emphasizing the importance of ongoing cardiac surveillance in this vulnerable population. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347787","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":"Temporal trends in myocardial ischemia risk estimated from 12-lead electrocardiograms using deep learning in individuals with suspected cancer during health checkups.","authors":"Ken Kurisu, Maiko Fujimori, Kohei Takeshita, Akira Fukui, Kyoko Ito, Keitaro Yokoyama, Tomohiro Kato, Tatsuo Akechi, Kazuhiro Yoshiuchi, Yosuke Uchitomi","doi":"10.1186/s40959-026-00466-2","DOIUrl":"10.1186/s40959-026-00466-2","url":null,"abstract":"<p><p>BACKGROUND: Previous studies have suggested the potential effect of psychological stress related to cancer diagnosis on cardiovascular mortality. This study aimed to investigate the temporal trends of cardiovascular risk before and after cancer diagnosis using a deep learning model applied to 12-lead electrocardiograms (ECGs). METHODS: We developed a deep learning model using a publicly available large-scale dataset to quantify myocardial ischemia risk from 12-lead ECGs. We collected ECG records from individuals diagnosed with cancer at a university hospital who also underwent an ECG as part of a health checkup within 90 days prior to cancer diagnosis. The deep learning model was then applied to the ECGs of individuals with cancer, and the temporal trend of cardiovascular risk was examined. RESULTS: The deep learning model demonstrated high predictive performance, with an area under the receiver operating characteristic curve of 0.930 (95% confidence interval = 0.920–0.941). The model was then applied to 523 ECG records of 89 individuals with cancer. The estimated probability of ECG-indicated myocardial ischemia increased until cancer diagnosis, peaked shortly after diagnosis, and then declined. CONCLUSIONS: These findings support the immediate effect of psychological stress related to cancer diagnosis on increased cardiovascular risks. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343546","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":"Intimal sarcomas (ISarc) of the cardiac chambers (CC) of the heart and great vessels (GV): a comprehensive genomic profiling (CGP) study.","authors":"Maroun Bou Zerdan, Dean Pavlick, Daniel J Zaccarini, Jeffrey Ross, Sergio Villegas De Leon, Elias A Castro, Sara Sfeir, Matthew Lee, Alina Basnet","doi":"10.1186/s40959-026-00459-1","DOIUrl":"10.1186/s40959-026-00459-1","url":null,"abstract":"<p><p>BACKGROUND: ISarc of the CC and GV are extremely rare primary tumors of the cardiac chambers (CC), aortic root (AO) and pulmonary artery (PA). These tumors are rarely resectable and are associated with rapid progression and poor clinical outcome. We queried whether CGP could uncover new routes to targeted therapies for this aggressive form of malignancy. METHODS: 27 cases of ISarc were centrally reviewed and required direct association with the intimal surfaces of the CC and GV with supporting routine histologic features and immunohistochemical staining patterns. DNA and RNA extracted from the ISarc cases were both sequenced using a hybrid-capture based CGP to study all classes of genomic alterations (GA) and determine MSI status, TMB level, HRD score, genomic ancestry, cosmic trinucleotide signature (Signature) and germline status. PD-L1 expression was measured by IHC (Dako 22C3 and TPS scoring). RESULTS: Among 27 ISarc cases (15 CC, 12 GV—11 pulmonary artery, 1 aortic root), most were high-grade tumors (89% grade 3, 11% grade 2). Median age was 45–46 years across groups. CC ISarc patients were more often female (73% vs 50%; P=0.26). Genomic alterations relevant to targeted therapy included MDM2 (67% CC, 50% GV), PDGFRA (53% CC, 42% GV), CDK4 (60% CC, 33% GV), and KIT (40% CC, 33% GV), though differences were not significant. CDKN2A deletions were more common in GV (67% vs 27%, P=0.055). PIK3CA mutations were significantly more frequent in CC (20% vs 0%, P=0.007); ERBB3 mutations were infrequent and not significant. EUR ancestry was seen in just over 50% of cases. Of four ISarc cases analyzed for mutational signatures, three had MMR and one APOBEC; none were MSI-high. Median TMB was similar (4.3–4.7 mut/Mb), with one CC case >10 mut/Mb. One GV case had germline VHL and KEAP1 mutations. Low PD-L1 expression was found in 1/5 (20%) of tested ISarc cases. CONCLUSIONS: CGP of ISarc cases reveals that these tumors do feature a modest number of GA potentially associated with benefit for targeted therapies but low and absent biomarkers predictive of immunotherapy benefit. Further study of ISarc in a setting of rare tumor clinical trials appears warranted. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321459","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":"Nedaplatin induced QT prolongation with polymorphic ventricular tachyarrhythmia: clinical experience and review of literature.","authors":"Jie Li, Sheng Ye, Jiming Chen, Min Ye, Fengjuan Yao, Huiling Huang","doi":"10.1186/s40959-026-00461-7","DOIUrl":"10.1186/s40959-026-00461-7","url":null,"abstract":"<p><p>BACKGROUND: Nedaplatin (NDP), a cisplatin derivative, is widely employed in the treatment of solid tumours. Commonly reported adverse effects include hypersensitivity, myelosuppression and nephrotoxicity. To date, QT-interval prolongation and polymorphic ventricular tachyarrhythmia have not been attributed to NDP. A 41-year-old Asian woman was referred to our institution with abdominal pain, diarrhoea and vomiting. Percutaneous biopsy confirmed a diagnosis of high-grade serous carcinoma with widespread metastatic dissemination. She sequentially received a PD-1 inhibitor, paclitaxel and NDP. Twenty minutes after NDP infusion commenced she developed abdominal pain, palpitations, nausea and hypotension (68/39 mmHg). ECG disclosed marked QT prolongation, polymorphic ventricular tachycardia and Mobitz type I second-degree atrioventricular block. Advanced life-support measures were instituted immediately. Following withdrawal of the implicated agent and substitution with carboplatin, she remained asymptomatic during 48 h of monitoring. CONCLUSION: We report the case of marked QT-interval prolongation and polymorphic ventricular tachycardia temporally related to NDP administration. Clinicians should therefore monitor the electrocardiogram closely during NDP therapy, particularly in patients receiving polypharmacy. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303021","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":"Association of sleep disturbance during breast cancer treatment and left ventricular ejection fraction decline: a prospective cohort study.","authors":"Warren Szewczyk, Kerryn W Reding, Ralph B D'Agostino, Richard K Cheng, Oxana Palesh, Kristine Olson, Amy Ladd, Kathryn E Weaver, Bonnie Ky, W Gregory Hundley","doi":"10.1186/s40959-026-00462-6","DOIUrl":"10.1186/s40959-026-00462-6","url":null,"abstract":"<p><p>Sleep disturbances during breast cancer (BC) treatment may represent a modifiable contributor to left ventricular ejection fraction (LVEF) decline during BC treatment. We investigated the association of sleep disturbance and LVEF decline in a prospective cohort of 247 women with non-metastatic BC scheduled for chemotherapy as part of the UPBEAT study conducted through the Wake Forest NCI Community Oncology Research Program Research Base (WF NCORP RB; WF-97415, UG1CA189824). Participants completed cardiac magnetic resonance imaging to measure LVEF, six-minute walk distance, and validated surveys assessing sleep disturbance, physical health, and mental health at baseline and 3 months. Sleep disturbance was measured using the Patient Reported Outcomes Measurement Information System Sleep Disturbance survey. At 3-month follow-up, 30.3% of participants experienced a clinically meaningful increase in sleep disturbance, with a mean LVEF decline of -4.13%-points compared to -1.93%-points in those without increased disturbance (p = 0.10). In multivariable models adjusting for baseline risk factors and concurrent changes in health, a 10-point increase in sleep disturbance was associated with a 1.31%-point reduction in LVEF (β= -0.131; 95% CI: -0.24,-0.02; p = 0.02). Associations were robust across sensitivity analyses. This study provides evidence linking sleep disturbance during BC treatment to early LVEF decline, suggesting sleep disturbance may contribute to subclinical cardiac dysfunction independent of general health decline. Longitudinal studies incorporating objective sleep measures are warranted to clarify mechanisms and evaluate whether behavioral interventions targeting sleep could mitigate cardiovascular risk in BC survivors.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275717","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":"Enhanced predictive value of post-treatment lymphocyte-based immunoinflammatory biomarkers for cancer therapy-related cardiac dysfunction in anthracycline-treated breast cancer patients.","authors":"Shilan Zhang, Heying Yin, SenSen Zhang, Jiachun Xia, Yanan Pang, Lei Hou","doi":"10.1186/s40959-026-00458-2","DOIUrl":"10.1186/s40959-026-00458-2","url":null,"abstract":"<p><p>BACKGROUND: Cancer therapy–related cardiac dysfunction (CTRCD) is a major cardiovascular complication in breast cancer patients receiving anthracycline-based chemotherapy, with the systemic inflammatory response playing a pivotal role in its pathogenesis. The association between lymphocyte-based immunoinflammatory biomarkers and CTRCD remains incompletely elucidated, particularly regarding the predictive value of dynamic changes in these indices. This study aimed to investigate the predictive value of lymphocyte-based immunoinflammatory biomarkers for CTRCD in breast cancer patients undergoing anthracycline treatment. METHODS: We retrospectively collected clinical data from breast cancer patients treated with anthracycline-based chemotherapy and conducted follow-up to monitor the development of CTRCD. Routine blood tests were performed pre- and post-anthracycline therapy, and seven lymphocyte-based immunoinflammatory indices (NLR, MLR, NMLR, SIRI, PLR, SII, PIV) were calculated accordingly. Receiver operating characteristic (ROC) curve analysis was used to compare the predictive value of these indices for CTRCD, while Kaplan-Meier curves and Cox regression analysis were performed for survival and risk factor assessment. RESULTS: A total of 75 patients were enrolled and followed up for a median of 27 months, with CTRCD observed in 9 (12%) cases. Lymphocyte-based immunoinflammatory biomarker levels were significantly elevated after anthracycline therapy. ROC curve analysis showed that post-treatment immunoinflammatory biomarkers had significantly higher predictive value for CTRCD than pre-treatment indices, with the AUCs of post-treatment MLR, NMLR, SIRI, SII, and PIV were 0.812, 0.828, 0.889, 0.803, 0.854 respectively. Additionally, post-treatment MLR, NMLR, SIRI, SII and PIV correlated significantly and positively with LVEF reduction at the 12th month, with correlation coefficients (r values) of 0.517 (P < 0.001), 0.552 (P < 0.001), 0.594 (P < 0.001), 0.415 (P < 0.001) and 0.559 (P < 0.001), respectively. Kaplan-Meier survival analysis revealed that patients with elevated post-treatment levels of these indices had a significantly increased risk of CTRCD. Multivariate Cox regression analysis further confirmed that post-treatment MLR (HR = 18.747, 95% CI = 1.871-187.799, p = 0.013), SIRI (HR = 2.877, 95% CI = 1.243–6.659, p = 0.014), and PIV (HR = 1.007, 95% CI = 1.002–1.012, p = 0.011) were independent predictors of CTRCD. CONCLUSION: Lymphocyte-based immunoinflammatory biomarkers assessed post-anthracycline therapy exhibit robust predictive value for CTRCD, with MLR, SIRI, and PIV serving as independent predictors of CTRCD in breast cancer patients receiving anthracycline-based chemotherapy. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146775993","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":"Electrocardiographic predictors of major adverse cardiovascular events in immune checkpoint inhibitor-associated myocarditis.","authors":"Kanghao Zhou, Guangcheng Liu, Bin Zhang, Xiong Zhang, Wei Wu","doi":"10.1186/s40959-026-00455-5","DOIUrl":"10.1186/s40959-026-00455-5","url":null,"abstract":"<p><p>BACKGROUND: Immune checkpoint inhibitor (ICI)–associated myocarditis carries a high risk of mortality, yet electrocardiographic (ECG) predictors of adverse outcomes remain unclear. The present study aimed to evaluate the predictive value of clinical and admission ECG parameters for major adverse cardiovascular events (MACE). METHODS: We retrospectively analyzed 60 consecutive patients with ICI myocarditis. Patients were stratified according to the occurrence of major adverse cardiovascular events (MACE), defined as myocarditis-related cardiogenic shock, high-degree atrioventricular block requiring temporary or permanent pacing, or sustained ventricular tachycardia(VT)/ventricular fibrillation(VF). Admission ECGs were systematically adjudicated for conduction and repolarization abnormalities, and an ECG burden score (0–6) was derived. Univariable and multivariable Firth penalized Cox regression models were used to identify predictors of MACE. Model performance was evaluated using discrimination and reclassification metrics across nested models: M1 (clinical variables), M2 (M1 + biomarkers and echocardiography), and M3 (M2 + ECG burden score). RESULTS: Among the 60 patients with myocarditis, MACE occurred in 21 patients (35%) patients. Compared with the non-MACE group, QTc prolongation (p = 0.011), QRS ≥ 120 ms((p = 0.002), Atrioventricular block (p = 0.007), bundle branch block (p = 0.005), ST-segment abnormalities (p = 0.003), and T-wave changes (p = 0.004) at the time of admission were more common in the MACE group. In multivariable Firth penalized Cox analysis, severe myocarditis, QTc prolongation, Atrioventricular block, QRS ≥ 120 ms, ST-segment abnormalities, T-wave changes, and higher ECG burden score independently predicted MACE. Sensitivity analyses excluding early MACE or in-hospital deaths confirmed robustness of results. Addition of ECG variables significantly improved model performance (C-index 0.726 [M1] vs. 0.860 [M2] vs. 0.941 [M3]), with significant net reclassification and integrated discrimination gains. CONCLUSION: Admission ECG abnormalities are powerful, independent predictors of adverse outcomes in ICI myocarditis and provide substantial incremental prognostic value beyond clinical and biomarker/echocardiographic features. Systematic ECG assessment and integration into risk stratification should be prioritized for early triage and monitoring in this high-risk population. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225426","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}