ReviewEuropean heart journal2019
Definition of hidden drug cardiotoxicity: paradigm change in cardiac safety testing and its clinical implications.
Review in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
82 citing papers in PubMed, 1 synthesis or guideline pooled it, 141 citations in OpenAlex.
- Early diagnostic value of high-sensitivity cardiac troponin T for cancer treatment-related cardiac dysfunction: a meta-analysis.ESC heart failure · 2023Pooled it
- Anthracycline cardiotoxicity: role of metabolic vulnerability induced by cardiac pressure overload.European heart journal · 2026Article
- Bioprinting High-Cell-Density Cardiac Tissue Constructs With Sustained Contractile Function.Advanced healthcare materials · 2026Article
- Cardiotoxicity of Targeted Therapies in Hematologic Malignancies: From Molecular Mechanisms to Clinical Management.Current treatment options in oncology · 2026Review
- Inhibition of the programmed death protein 1 immune checkpoint and the development of heart failure in the presence of prior cardiac ischaemia.Cardiovascular research · 2026Article
- Integrated Electrophysiological and Optical Analysis of Human iPSC-Derived Cardiomyocytes Using Transparent ITO Microelectrode Chip.International journal of stem cells · 2026Article
- Cardiovascular adverse effects of common non-oncologic medications: from mechanisms to clinical management.European heart journal. Cardiovascular pharmacotherapy · 2026Review
- Non-Invasive electrophysiological monitoring of cardiac organoids using 3D-Net-assisted microelectrodes array platform.Scientific reports · 2026Article
- mRNA-based SARS-CoV-2 vaccines: intracellular processing and aggregation of the encoded spike protein as a mechanistic contributor to cardiac cellular stress.Frontiers in immunology · 2026Article
- Protective Effects of Ginsenosides on Drug-induced Cardiotoxicity: A New Therapeutic Approach with Focus on Molecular Mechanisms in Cardio-oncology Field.Current medicinal chemistry · 2026Review
- Human induced pluripotent stem cell-derived cardiomyocytes and their use in a cardiac organ-on-a-chip to assay electrophysiology, calcium and contractility.Nature protocols · 2025Review
- Hemoglobin is associated with cardiotoxicity in melanoma patients without anemia receiving immune checkpoint inhibitor therapy.International journal of cardiology. Heart & vasculature · 2025Article
- Anthracycline-induced cardiomyopathy: risk prediction, prevention and treatment.Nature reviews. Cardiology · 2025Review
- Evaluating the Characteristics and Outcomes of Acute Pharmaceutical Exposure in Children: 5-Year Retrospective Study.JMIR pediatrics and parenting · 2025Article
- Engineered ACE2 decoy in dry powder form for inhalation: A novel therapy for SARS-CoV-2 variants.Molecular therapy. Methods & clinical development · 2025Article
- Induced Pluripotent Stem Cells in Cardiomyopathy: Advancing Disease Modeling, Therapeutic Development, and Regenerative Therapy.International journal of molecular sciences · 2025Review
- IMproving Preclinical Assessment of Cardioprotective Therapies (IMPACT): a small animal acute myocardial infarction randomized-controlled multicenter study on the effect of ischemic preconditioning.Basic research in cardiology · 2025Article
- Heart-on-a-Miniscope: A Miniaturized Solution for Electrophysiological Drug Screening in Cardiac Organoids.Small (Weinheim an der Bergstrasse, Germany) · 2025Article
- Preclinical models of cardiotoxicity from immune checkpoint inhibitor therapy.Basic research in cardiology · 2025Review
- Precision cardiovascular medicine: shifting the innovation paradigm.Frontiers in science · 2025Article
22 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
Abstract
Unexpected cardiac adverse effects are the leading causes of discontinuation of clinical trials and withdrawal of drugs from the market. Since the original observations in the mid-90s, it has been well established that cardiovascular risk factors and comorbidities (such as ageing, hyperlipidaemia, and diabetes) and their medications (e.g. nitrate tolerance, adenosine triphosphate-dependent potassium inhibitor antidiabetic drugs, statins, etc.) may interfere with cardiac ischaemic tolerance and endogenous cardioprotective signalling pathways. Indeed drugs may exert unwanted effects on the diseased and treated heart that is hidden in the healthy myocardium. Hidden cardiotoxic effects may be due to (i) drug-induced enhancement of deleterious signalling due to ischaemia/reperfusion injury and/or the presence of risk factors and/or (ii) inhibition of cardioprotective survival signalling pathways, both of which may lead to ischaemia-related cell death and/or pro-arrhythmic effects. This led to a novel concept of 'hidden cardiotoxicity', defined as cardiotoxity of a drug that manifests only in the diseased heart with e.g. ischaemia/reperfusion injury and/or in the presence of its major comorbidities. Little is known on the mechanism of hidden cardiotoxocity, moreover, hidden cardiotoxicity cannot be revealed by the routinely used non-clinical cardiac safety testing methods on healthy animals or tissues. Therefore, here, we emphasize the need for development of novel cardiac safety testing platform involving combined experimental models of cardiac diseases (especially myocardial ischaemia/reperfusion and ischaemic conditioning) in the presence and absence of major cardiovascular comorbidities and/or cotreatments.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.