ArticleJACC. CardioOncology2021
Refining the 10-Year Prediction of Left Ventricular Systolic Dysfunction in Long-Term Survivors of Childhood Cancer.
Article in JACC. CardioOncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses 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
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Cardiotoxicity in pediatric oncology: a systematic review and meta-analysis.Pediatric research · 2026Pooled it
- Risk prediction models for cancer therapy related cardiac dysfunction in patients with cancer and cancer survivors: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Asymptomatic systolic dysfunction on contemporary echocardiography in anthracycline-treated long-term childhood cancer survivors: a systematic review.Journal of cancer survivorship : research and practice · 2022Pooled it
- Left ventricular function and its longitudinal change in Swiss childhood cancer survivors - results from the CardioOnco study.Cardio-oncology (London, England) · 2026Article
- Management of late toxicities and specific follow-up needs of adolescent and young adult cancer survivors: recommendations from scientific societies in Spain.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Deep Learning-Based Automated Echocardiographic Measurements in Pediatric and Congenital Heart Disease.medRxiv : the preprint server for health sciences · 2026Article
- Predicting the 10-year risk of cardiomyopathy in long-term survivors of childhood cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2025Article
- Obesity Predisposes Anthracycline-Treated Survivors of Childhood and Adolescent Cancers to Subclinical Cardiac Dysfunction.Pediatric cardiology · 2025Article
- Heart failure in patients with congenital heart disease after a cancer diagnosis.ESC heart failure · 2024Article
- Cancer and Heart Failure: Dangerous Liaisons.Journal of cardiovascular development and disease · 2024Review
- The burden of cardiovascular disease and risk for subsequent major adverse cardiovascular events in survivors of childhood cancer: a prospective, longitudinal analysis from the St Jude Lifetime Cohort Study.The Lancet. Oncology · 2024Article
- Presence and utility of electrocardiographic abnormalities in long-term childhood cancer survivors.Heart (British Cardiac Society) · 2024Article
- Improved Cardiomyopathy Risk Prediction Using Global Longitudinal Strain and N-Terminal-Pro-B-Type Natriuretic Peptide in Survivors of Childhood Cancer Exposed to Cardiotoxic Therapy.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Rurality, Cardiovascular Risk Factors, and Early Cardiovascular Disease among Childhood, Adolescent, and Young Adult Cancer Survivors.Research square · 2024Article
- Improving quality and quantity of life for childhood cancer survivors globally in the twenty-first century.Nature reviews. Clinical oncology · 2023Review
- Longitudinal strain analysis for assessment of early cardiotoxicity during anthracycline treatment in childhood sarcoma: A single center experience.Cancer reports (Hoboken, N.J.) · 2023Article
- Risk Prediction Models for Myocardial Dysfunction and Heart Failure in Patients with Current or Prior Cancer.Current oncology reports · 2023Review
- MicroRNA composition of plasma extracellular vesicles: a harbinger of late cardiotoxicity of doxorubicin.Molecular medicine (Cambridge, Mass.) · 2022Article
- Cardiac Events in Childhood Cancer Survivors Treated with Anthracyclines: The Value of Previous Myocardial Strain Measurement.Life (Basel, Switzerland) · 2022Article
- Automated Global Longitudinal Strain Assessment in Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia.Cancers · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn childhood cancer survivors (CCS) at risk for heart failure, echocardiographic surveillance recommendations are currently based on anthracyclines and chest-directed radiotherapy dose. Whether the ejection fraction (EF) measured at an initial surveillance echocardiogram can refine these recommendations is unknown.
objectivesThe purpose of this study was to assess the added predictive value of EF at >5 years after cancer diagnosis to anthracyclines and chest-directed radiotherapy dose in CCS, for the development of left ventricular dysfunction with an ejection fraction <40% (LVD40).
methodsEchocardiographic surveillance was performed in 299 CCS from the Emma Children's Hospital in the Netherlands. Cox regression models were built including cardiotoxic cancer treatment exposures with and without EF to estimate the probability of LVD40 at 10-year follow-up. Calibration, discrimination, and reclassification were assessed. Results were externally validated in 218 CCS.
resultsCumulative incidences of LVD40 at 10-year follow-up were 3.7% and 3.6% in the derivation and validation cohort, respectively. The addition of EF resulted in an integrated area under the curve increase from 0.74 to 0.87 in the derivation cohort and from 0.72 to 0.86 in the validation cohort (likelihood ratio p < 0.001). Reclassification of CCS without LVD40 improved significantly (noncase continuous net reclassification improvement 0.50; 95% confidence interval [CI]: 0.40 to 0.60). A predicted LVD40 probability ≤3%, representing 75% of the CCS, had a negative predictive value of 99% (95% CI: 98% to 100%) for LVD40 within 10 years. However, patients with midrange EF (40% to 49%) at initial screening had an incidence of LVD40 of 11% and a 7.81-fold (95% CI: 2.07- to 29.50-fold) increased risk of LV40 at follow-up.
conclusionsIn CCS, an initial surveillance EF, in addition to anthracyclines and chest-directed radiotherapy dose, improves the 10-year prediction for LVD40. Through this strategy, both the identification of low-risk survivors in whom the surveillance frequency may be reduced and a group of survivors at increased risk of LVD40 could be identified.
Indexed as
Identifiers
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.