ArticleAmerican journal of cancer research2026
Risk factors for cardiac dysfunction caused by anthracycline drugs in the treatment of lymphoma and the early monitoring value of three-dimensional echocardiography.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Anthracyclines (ANTs) are important chemotherapeutic drugs for the treatment of lymphoma. However, its cardiotoxicity poses a challenge to its continued use. The development of ARCD is influenced by multiple factors, making early detection challenging. Three-dimensional speckle tracking imaging (3D-STI) can quantitatively analyze myocardial strain by tracking the movement of myocardial spots. This study compared the parameters derived from conventional echocardiography, 3D-STI, and three-dimensional echocardiography at baseline (T0), 2 cycles of chemotherapy (T2) and 4 cycles of chemotherapy (T4), and analyzed the risk factors for ARCD. From January 2020 to December 2024, a total of 189 patients with non-Hodgkin lymphoma were recruited, all of whom received at least 4 cycles of ANT treatment. During chemotherapy and follow-up, 28 patients developed ARCD. Firth-penalized logistic regression demonstrated that age ≥65 years (aOR = 3.416, 95% CI: 1.241-9.913), hypertension (aOR = 3.051, 95% CI: 1.095-8.675), and cumulative ANT dose (aOR = 1.028, 95% CI: 1.017-1.040) were independently associated with an increased risk of ARCD. Conventional echocardiographic parameters, including LVEF, showed no significant changes. Compared with T0, right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) were significantly increased at T4 (P<0.05), left ventricular global longitudinal strain (LVGLS) was significantly decreased at T2 (P<0.05), and left ventricular global circumferential strain (LVGCS) was significantly decreased at T4 (P<0.05). The absolute change in LVGLS from T0 to T2 (ΔLVGLS) was significantly and positively correlated with the cumulative ANT dose (R = 0.336, P<0.001). The cut-off value for predicting ARCD using ΔLVGLS was 3.5%. The area under the curve (AUC) was 0.852 and the respective sensitivity and specificity were 0.929 and 0.739. 3D-STI, particularly LVGLS, demonstrated significant value in the early identification of cardiac dysfunction in patients with lymphoma undergoing ANT treatment.
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