Evidence map›Paper›PMID 37496091›Full record

ArticleRadiation oncology (London, England)2023

Radiotherapy-induced diffuse myocardial fibrosis in early-stage breast cancer patients - multimodality imaging study with six-year follow-up.

Mikko Moisander, Tanja Skyttä, Sari Kivistö, Heini Huhtala, Kjell Nikus, Vesa Virtanen, Pirkko-Liisa Kellokumpu-Lehtinen, Pekka Raatikainen, Suvi Tuohinen

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In one paragraph

Article in Radiation oncology (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. Review
  7. Heart is a heavy burden: cardiac toxicity in radiation oncology.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Review
  8. Review
  9. Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mikko MoisanderFaculty of Medicine and Health Technology, Tampere University, PO Box 100, Tampere, 33014, Finland. mikko.moisander@pirha.fi.
Tanja SkyttäFaculty of Medicine and Health Technology, Tampere University, PO Box 100, Tampere, 33014, Finland.
Sari KivistöRadiology, HUS Diagnostic Center University of Helsinki and Helsinki University Hospital, PO Box 100, Helsinki, 00029, Finland.
Heini HuhtalaFaculty of Social Sciences, Tampere University, PO Box 100, Tampere, 33014, Finland.
Kjell NikusFaculty of Medicine and Health Technology, Tampere University, PO Box 100, Tampere, 33014, Finland.
Vesa VirtanenHeart Hospital, Tampere University Hospital, PO Box 2000, Tampere, 33521, Finland.
Pirkko-Liisa Kellokumpu-LehtinenFaculty of Medicine and Health Technology, Tampere University, PO Box 100, Tampere, 33014, Finland.
Pekka RaatikainenHeart and Lung Center, Helsinki University Central Hospital and Helsinki University, PO Box 100, Helsinki, 00029, Finland.
Suvi TuohinenHeart Hospital, Tampere University Hospital, PO Box 2000, Tampere, 33521, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreast radiotherapy (RT) induces diffuse myocardial changes, which may increase the incidence of heart failure with preserved ejection fraction. This study aimed to evaluate the early signs of diffuse fibrosis after RT and their evolution during a six-year follow-up.

methodsThirty patients with early-stage left-sided breast cancer were studied with echocardiography and electrocardiography (ECG) at baseline, after RT, and at three-year and six-year follow-up visits. Echocardiography analysis included an off-line analysis of integrated backscatter (IBS). ECG was analysed for fragmented QRS (fQRS). In addition, cardiac magnetic resonance (CMR) imaging was performed at the six-year control. The left ventricle 16-segment model was used in cardiac imaging, and respective local radiation doses were analysed.

resultsRegional myocardial reflectivity in inferoseptal segments increased by 2.02 (4.53) dB (p = 0.026) and the percentage of leads with fQRS increased from 9.2 to 16.4% (p = 0.002) during the follow-up. In CMR imaging, abnormal extracellular volume (ECV) and T1 mapping values were found with anteroseptal and apical localization in a median of 3.5 (1.00-5.75) and 3 (1.25-4.00) segments, respectively. A higher left ventricle radiation dose was associated with an increased likelihood of having changes simultaneously in CMR and echocardiography (OR 1.26, 95% Cl. 1.00-1.59, p = 0.047).

conclusionsAfter radiotherapy, progressive changes in markers of diffuse myocardial fibrosis were observed in a multimodal manner in ECG and echocardiography. Changes in echocardiography and abnormal values in CMR were localized in the septal and apical regions, and multiple changes were associated with higher radiation doses.

Indexed as

Breast NeoplasmsFemaleFibrosisFollow-Up StudiesHeartHumansMyocardiumAdjuvant RadiotherapyBreast neoplasmsCardiac ElectrophysiologyCardiotoxicityEchocardiographyEndomyocardial FibrosisMultiparametric magnetic resonance imaging

Identifiers

PMID37496091
PMCPMC10373367

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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.