ArticleJACC. Clinical electrophysiology2026
Early and Late Myocardial Effects of Proton Beam Cardiac Radioablation: Insights From Gene Expression Analysis.
Article in JACC. Clinical electrophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Stereotactic arrhythmia radioablation for ventricular tachycardia: Mechanisms, workflow, outcomes, and future directions.Heart rhythm O2 · 2026Review
- Standardized processing of explanted hearts after stereotactic arrhythmia radiotherapy (Bio-STAR): a STOPSTORM framework and first human findings.European heart journal open · 2026Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundCardiac radioablation (CRA) is an emerging treatment modality for refractory ventricular tachycardia. The mechanisms underlying the antiarrhythmic effect of CRA remain incompletely understood.
objectivesThe goal of this study was to investigate the nature and time course of key gene expression of apoptosis, conduction, and fibrosis after 40 Gy proton beam CRA.
methodsIn 18 swine, left ventricular (LV) targets were treated with a single-fraction 40 Gy proton beam. Myocardium was harvested from an irradiated LV target (IR-40Gy LV), the border area (IR-Border LV), and non-irradiated remote location (Remote LV) 1 to 32 weeks later. Apoptosis was assessed with the terminal deoxynucleotidyl transferase dUTP nick end labeling method that detects DNA breaks in the late phase of apoptosis. Markers of cellular survival, electrical conduction, and fibrosis were also assessed with real-time polymerase chain reaction.
resultsTerminal deoxynucleotidyl transferase dUTP nick end labeling staining suggested ongoing apoptosis in IR-40Gy LV through 20 to 32 weeks, with a peak at 4 to 8 weeks. Statistically significant expression reduction of TNNT2 (encoding cardiac troponin T) was noted in the IR-40Gy LV group compared with the Remote LV group at 1 to 2 weeks and through 20 to 32 weeks. IR-40Gy LV and IR-Border LV showed patterns of expression reduction of genes of myocardial conduction, including SCN5A, GJA1, and GJA5 (encoding Na
conclusionsApoptosis peaked at 4 to 8 weeks and continued during several months of follow-up after proton beam irradiation. There was no evidence of up-regulation of conduction markers early after irradiation. Activation of fibrosis pathways occurred several weeks after irradiation.
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