ArticleJACC. CardioOncology2025
Cardiac Effects of Modern Breast Radiation Therapy in Patients Receiving Systemic Cancer Therapy.
Article in JACC. CardioOncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed.
- Cardiac remodelling and dysfunction in cancer patients receiving cardiotoxic therapies: proteomic and metabolomic profiling.European heart journal · 2026Article
- Risk-guided cardioprotection in cardio-oncology.Nature cardiovascular research · 2026Review
- Dosimetric impact of aperture-restricted VMAT on heart dose in breast cancer treated with regional nodal irradiation.Journal of applied clinical medical physics · 2026Article
- Heart Substructure Radiation Dose and Cardiac Outcomes: Contemporary Evidence and Actionable Opportunities: JACC CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2026Review
- Impact of Radiation Therapy on Diastolic Function and Cardiac Troponin I Levels in Cancer Patients Undergoing Contemporary Radiotherapy.Circulation reports · 2026Article
- Changes in Cardiac Function in Patients Receiving Radiation Therapy for Lung Cancer.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2026Article
- Early cardiotoxicity of radiotherapy in breast cancer patients after chemotherapy: the early warning sign.Journal of the Egyptian National Cancer Institute · 2026Observational
- Imaging in Cardio-Oncology: Role of Novel Echo Parameters in Breast Cancer and Gynecologic Malignancies.Current cardiology reports · 2026Review
- Air Pollution and Cardiac Remodeling and Function in Patients With Breast Cancer.JAMA network open · 2026Article
- Imaging-based detection and prediction of radiation-induced cardiac toxicity: a narrative review.BJR open · 2026Review
- Cardiovascular disease risk following radiotherapy among breast cancer survivors: a nationwide cohort study in South Korea.Breast cancer research : BCR · 2025Article
- Association between cardiac radiation dose and coronary artery calcification progression in breast cancer patients after radiotherapy: the modifying role of concomitant systemic inflammation (BACCARAT study).Cardio-oncology (London, England) · 2025Article
- Seeding the Soil for HFpEF: The Diastolic Legacy of Modern Breast Radiotherapy.JACC. CardioOncology · 2025Article
- Evolving Cardioprotective Strategies in Cardio-Oncology: A Narrative Review.Current cardiology reports · 2025Review
- 3D Echocardiographic Phenotyping of Left Ventricular Mechanics and Function With Contemporary Radiation Therapy.Advances in radiation oncology · 2025Article
- Beyond Mean Heart Dose: Rethinking Cardiac Dysfunction and Risk Assessment in Breast Radiation Therapy.JACC. CardioOncology · 2025Article
Corrections and comments
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Authors and funding
24 authors.
Funding
Abstract
backgroundRadiation therapy (RT) improves breast cancer outcomes, but cardiac morbidity remains a concern.
objectivesThis study sought to evaluate changes in cardiac function after RT and the relationship between cardiac dose metrics and echocardiography-derived measures of function.
methodsIn a longitudinal cohort study of women with breast cancer, radiation cardiac dose metrics and core lab quantitated echocardiographic measures of cardiac function were evaluated. Dose metrics included the whole heart, left ventricle, right ventricle, and left anterior descending artery (LAD). Echocardiographic measures included left ventricular ejection fraction (LVEF), longitudinal strain, circumferential strain, E/e' (ratio of early diastolic mitral inflow velocity to early diastolic mitral annular tissue velocity), Ea/Es (ventricular arterial coupling; ratio of effective arterial elastance to end systolic elastance), and right ventricular fractional area change. The mean change in echocardiographic measures over time and the association between cardiac dose metrics and echocardiographic measures were estimated by repeated-measures multivariable linear regression via generalized estimating equations.
resultsThe cohort included 303 participants (median age 52 years, 33.3% African American) who received adjuvant RT (2010-2019) with a median mean heart dose of 1.19 Gy (Q1-Q3: 0.75-2.61 Gy), were followed over a median of 5.1 years (Q1-Q3: 3.2-7.1 years). Across all participants, there was a modest increase in LVEF (52.1% pre-RT to 54.3% at 5 years; P < 0.001) but a worsening in sensitive measures of function, such as circumferential strain (-23.7% pre-RT to -21.0% at 5 years; P = 0.003). Among left-sided/bilateral breast cancer participants, changes in cardiac function were observed across all parameters (P < 0.05). The maximum LAD dose was associated with a modest worsening in LVEF, longitudinal strain, circumferential strain, and E/e'.
conclusionsOver a median of 5.1 years, modest changes in cardiac function were observed with RT. Maximum LAD dose was associated with a worsening in systolic and diastolic function parameters.
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