{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:17:39Z","timestamp":1787761059001,"version":"build-2784847793"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006058","name":"St. Baldrick's Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006058","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL163456"],"award-info":[{"award-number":["K23HL163456"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Anthracycline\u2010related cardiac remodeling precedes heart failure in childhood cancer survivors. The objectives of this study were to determine the relationships between patient\u2010specific factors, moderate\u2010to\u2010vigorous physical activity (MVPA), and cardiac remodeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a prospective, observational, cross\u2010sectional study in \u2265 2\u2010year survivors treated with anthracyclines. We derived MVPA from accelerometry and cardiac parameters (indexed end\u2010diastolic left ventricular [LV] mass [LVMi], volume [LVEDVi], mass:volume ratio, and LV ejection fraction [LVEF]) from cardiovascular magnetic resonance imaging. We assessed predictors of MVPA and the association between MVPA and cardiac parameters using multivariable linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 112 participants, mean age was 18.2 years (standard deviation [SD] 3.0) and mean anthracycline dose was 239\u00a0mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (SD 146). Mean MVPA was 134 min\/week (SD 124) and 72 (64%) participants had &lt; 150\u00a0min\/week. Independent predictors of lower MVPA were lower age, female sex, and Hispanic ethnicity (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Higher age and male sex were associated with higher LVMi and LVEDVi; higher age at cancer diagnosis, male sex, and obesity were associated with higher mass:volume ratio; and higher anthracycline dose was associated with lower LVEF (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Every 100 additional weekly minutes of MVPA was associated with a 1.4\u00a0g\/m\n                      <jats:sup>2<\/jats:sup>\n                      higher LVMi (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008) and 1.9\u00a0mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      higher LVEDVi (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Physical activity levels were suboptimal and higher levels of MVPA were associated with higher LV mass and volume. Our findings suggest the need to promote physical activity in childhood cancer survivors and that exercise may mitigate anthracycline\u2010related cardiac remodeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trials Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifiers: NCT04262830<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70523","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T07:27:16Z","timestamp":1784964436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship Between Physical Activity and Left Ventricular Remodeling in Childhood Cancer Survivors Treated With Anthracyclines: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"73","author":[{"given":"Hari K.","family":"Narayan","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of California, San Diego  La Jolla California USA"},{"name":"Department of Pediatrics Rady Children's Hospital San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sitong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Population Sciences City of Hope  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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