ArticleJACC. Case reports2026
Chemotherapy as Second Hit in Desmoplakin Cardiomyopathy.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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
1 citing paper in PubMed.
- Second Hits Are Common Drivers of Genetic Heart Disease.JACC. Case reports · 2026Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCancer therapy-related cardiac dysfunction is traditionally considered an acquired cardiomyopathy; however, genetic susceptibility may predispose patients to disproportionate myocardial injury, supporting a second-hit model. CASE SUMMARY: A 37-year-old woman with breast cancer and no cardiovascular history developed left ventricular dysfunction during anthracycline chemotherapy, with further deterioration after anti-human epidermal growth factor receptor 2 therapy. Cardiovascular magnetic resonance demonstrated biventricular dysfunction, ventricular dilatation, and ring-like subepicardial late gadolinium enhancement, atypical for isolated cardiotoxicity. Genetic testing revealed a pathogenic loss-of-function Desmoplakin variant, establishing DSP-related cardiomyopathy. Anti-human epidermal growth factor receptor 2 therapy was discontinued, heart failure therapy optimized, and an implantable cardioverter-defibrillator implanted for primary prevention. DISCUSSION: This case shows how chemotherapy may unmask latent genetic cardiomyopathy, emphasizing the diagnostic value of tissue characterization and genetic testing when ventricular dysfunction is unexpected. TAKE-HOME MESSAGE: Severe ventricular dysfunction during cancer therapy should prompt genetic evaluation, with cardiovascular magnetic resonance and genetic testing playing a key role in guiding diagnosis and risk stratification.
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