Evidence mapPaperPMID 42322372Full record

ArticleESC heart failure2026

Early anthracycline cardiotoxicity in adolescents and young adults with sarcoma: a prospective echocardiographic study.

Efstratios Koutroumpakis, Efthymios Triantafyllou, John Andrew Livingston, Juhee Song, Claire Viguet, Andres Hughes, Savannah V Rauschendorfer, Prince Jeyabal, Theresa A Honey, Joya Chandra and 7 more

Abstract read
In one paragraph

Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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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

17 authors.

Efstratios KoutroumpakisDepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USA.ORCID 0000-0002-6757-6480
Efthymios TriantafyllouDepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USA.ORCID 0009-0003-4297-8816
John Andrew LivingstonDepartment of Sarcoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Juhee SongDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID 0000-0002-8688-4104
Claire ViguetDepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USA.
Andres HughesDepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USA.
Savannah V RauschendorferDepartment of Health, Human Performance, and Recreation, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
Prince JeyabalDivision of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Theresa A HoneyDivision of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Joya ChandraDivision of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID 0000-0002-2077-9715
Najat C DawDivision of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Michelle A T HildebrandtDepartment of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jose BanchsDivision of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
Susan C GilchristDivision of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Michael E RothDivision of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Anita DeswalDepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USA.ORCID 0000-0002-6147-9591
Eugenie S KleinermanDivision of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Funding

Protocol Review and Monitoring SystemP30CA016672 · UNIVERSITY OF TX MD ANDERSON CAN CTR · 1985 to 2025
$57.3M
Cancer Prevention & Research Institute of Texas RP200381NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

backgroundAdolescents and young adults (AYAs) with sarcomas often receive high-dose doxorubicin (Dox), but data on early cardiotoxicity in this population are limited.

objectivesTo prospectively evaluate early echocardiographic changes in AYAs with sarcoma treated with high-dose Dox.

methodsAYAs (15-39 years) with sarcoma treated at a tertiary cancer centre (2018-22) were prospectively enroled. Echocardiograms were performed at baseline, 1 and 2 years after cancer therapy initiation and interpreted by a single cardiologist. The primary endpoint was a >10% absolute reduction in left ventricular ejection fraction (LVEF), an absolute LVEF <50%, or >10% decrease in LV wall thickness/dimension (LVWT/D) ratio from baseline. Secondary endpoints included longitudinal changes in cardiac structure, chamber volumes, systolic and diastolic function, and strain.

resultsOf 70 patients, 56 completed at least two of three study echocardiograms (median age 22.6 [IQR, 17.6-30.5] years; 41% female, 84% white). Median cumulative Dox dose was 450 (IQR, 370-450) mg/m2; 75% received dexrazoxane. The primary endpoint was met by 44.4% at 1 year and 27.5% at 2 years, driven primarily by LVWT/D ratio decline (37% at 1 year, 25% at 2 years), while significant LVEF decline was observed in 11.1% and 2.5%, respectively. Significant absolute changes at 1 year included LVEF (-2.73 ± 4.3%, P < .001), global longitudinal strain magnitude (-1.37 ± 2.56%, P = .002), septal e' (-1.75 ± 2.48 cm/s, P < .001), and lateral e' (-2.78 ± 3.44 cm/s, P < .001), persisting at 2 years. One patient (1.8%) developed ventricular fibrillation and heart failure with reduced ejection fraction, with LVEF recovery within 1 year.

conclusionsOver one-third of AYAs with sarcoma met the primary endpoint at 1 year, with half of these abnormalities persisting at 2 years, primarily driven by LVWT/D ratio reductions. Subclinical changes in strain and diastolic function were observed, reflecting the broad cardiac impact of high-dose Dox in this population.

Indexed as

AnthracyclinesCardiotoxicityEchocardiographyHeart VentriclesSarcomaStroke VolumeVentricular Function, LeftAdolescentAdultAntibiotics, AntineoplasticDose-Response Relationship, DrugDoxorubicinFemaleFollow-Up StudiesGlobal Longitudinal StrainHumansAnthracyclinesAntibiotics, AntineoplasticDoxorubicinCardiotoxicityChemotherapyDoxorubicinEarly echo findingsSarcoma survivors

Identifiers

PMID42322372
PMCPMC13282902

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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 Socratic graph.