ArticleEuropean radiology2024
Long-term cardiotoxicity in germ cell cancer survivors after platinum-based chemotherapy: cardiac MR shows impaired systolic function and tissue alterations.
Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Article
- Platinum accumulation in chemotherapy: toxicity mechanisms, challenges, and mitigation strategies.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Review
- Valvular and Outflow Tract Metastases From Germ Cell Tumors: Contrasting Left-Sided Embolism and Right-Sided Silence.JACC. Case reports · 2026Article
- Increased cardiovascular disease risk among adolescent and young adult survivors of cervical cancer.Journal of gynecologic oncology · 2025Article
- Platinum-based chemotherapies-induced nephrotoxicity: mechanisms, potential treatments, and management.International urology and nephrology · 2025Review
- Mechanisms of cisplatin sensitivity and resistance in testicular germ cell tumors and potential therapeutic agents (Review).Experimental and therapeutic medicine · 2025Review
- Cardiotoxicity in platinum-based chemotherapy: Mechanisms, manifestations, and management.Cancer pathogenesis and therapy · 2025Review
- Cardiovascular toxicity in testicular germ cell tumor survivors.Frontiers in oncology · 2025Review
- The increasing role of cardiac magnetic resonance to evaluate cardiotoxicity of platinum-based chemotherapy: lessons learnt from asymptomatic germ cell cancer survivors.European radiology · 2024Article
- Joy at work: how to build a happy and resilient next generation of radiologists.European radiology · 2024Article
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14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLong-term toxicities of germ cell cancer (GCC) treatment are of particular importance in young men with a life expectancy of several decades after curative treatment. This study aimed to investigate the long-term effects of platinum-based chemotherapy on cardiac function and myocardial tissue in GCC survivors by cardiac magnetic resonance (CMR) imaging.
methodsAsymptomatic GCC survivors ≥ 3 years after platinum-based chemotherapy and age-matched healthy controls underwent CMR assessment, including left ventricular (LV) and right ventricular (RV) ejection fraction (EF), strain analysis, late gadolinium enhancement (LGE) imaging, and T1/T2 mapping.
resultsForty-four survivors (age 44 [interquartile range, IQR 37-52] years; follow-up time 10 [IQR 5-15] years after chemotherapy) and 21 controls were evaluated. LV- and RVEF were lower in GCC survivors compared to controls (LVEF 56 ± 5% vs. 59 ± 5%, p = 0.017; RVEF 50 ± 7% vs. 55 ± 7%, p = 0.008). Seven percent (3/44) of survivors showed reduced LVEF (< 50%), and 41% (18/44) showed borderline LVEF (50-54%). The strain analysis revealed significantly reduced deformation compared to controls (LV global longitudinal strain [GLS] -13 ± 2% vs. -15 ± 1%, p < 0.001; RV GLS -15 ± 4% vs. -19 ± 4%, p = 0.005). Tissue characterization revealed focal myocardial fibrosis in 9 survivors (20%) and lower myocardial native T1 times in survivors compared to controls (1202 ± 25 ms vs. 1226 ± 37 ms, p = 0.016). Attenuated LVEF was observed after two cycles of platinum-based chemotherapy (54 ± 5% vs. 62 ± 5%, p < 0.001).
conclusionBased on CMR evaluation, combination chemotherapy with cumulative cisplatin ≥ 200 mg/m CLINICAL RELEVANCE STATEMENT: Platinum-based chemotherapy is associated with decreased systolic function, non-ischemic focal myocardial scar, and decreased T1 times in asymptomatic long-term germ cell cancer survivors. Clinicians should be particularly aware of the risk of cardiac toxicity after platinum-based chemotherapy. KEY POINTS: • Platinum-based chemotherapy is associated with attenuation of biventricular systolic function, lower myocardial T1 relaxation times, and non-ischemic late gadolinium enhancement. • Decreased systolic function and non-ischemic late gadolinium enhancement are associated with a cumulative cisplatin dose of ≥ 200 mg/m
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