{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:40:58Z","timestamp":1791319258648,"version":"4.3.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":484,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Anthracycline chemotherapy (AC) for breast cancer can cause cancer therapy-related cardiac dysfunction (CTRCD) with resultant heart failure, traditionally defined as a reduction in left ventricular (LV) ejection fraction on echocardiography. In recent years, global longitudinal systolic strain (GLS) has been used to identify subclinical cardiac dysfunction prior to development of overt CTRCD. Recent harmonized guidelines have incorporated GLS into definitions for CTRCD to identify cardiac dysfunction and inform decisions regarding cardioprotective strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We evaluated subclinical dysfunction in breast cancer patients treated with AC and determined the echocardiographic and patient factors associated with significant GLS changes. One hundred fourteen HER2 negative patients treated with AC were prospectively recruited and underwent serial echocardiograms (LVEF and LVGLS) at three time points (prior to AC, 3 months, and 1 year). CTRCD was defined as an asymptomatic reduction in LVEF of 10% or symptomatic drop of 5% to LVEF &amp;lt;53%. Subclinical LV dysfunction was defined as a reduction of \u226510% in GLS compared with baseline, recognizing that this cut off identified an \u2018at risk cohort\u2019 rather than patients with established CTRCD. No participant demonstrated CTRCD by reduction in LVEF. Forty-three patients (38%) demonstrated a \u226510% relative reduction in GLS at 12 months; 20\/43 (47%) had a reduced absolute GLS to &amp;lt;16%, and were older, had hypertension, increased LV mass, lower baseline e\u2032 velocity and GLS. GLS \u226520.5% at baseline yielded a sensitivity of 79% and specificity of 87% for a normal GLS (i.e., \u226516%) at 1 year despite a \u226510% reduction from baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We present a stepwise evaluation for subclinical LV dysfunction using both a relative reduction in GLS combined with an absolute reduction in GLS. We believe our findings may re-stratify patients with a high baseline GLS into a lower risk group despite transient relative GLS decrements \u226510%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14884","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T03:27:42Z","timestamp":1718681262000},"page":"3210-3221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Redefining Anthracycline-Related Subclinical Cardiotoxicity: \u2018Absolute\u2019 and \u2018Relative\u2019 Change in Longitudinal Strain"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0798-0543","authenticated-orcid":false,"given":"Andrew","family":"Terluk","sequence":"first","affiliation":[{"name":"Westmead Clinical School, The University of Sydney , Camperdown ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Stefani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Westmead Hospital , Sydney ,","place":["Australia"]},{"name":"Westmead Applied Research Centre, The University of Sydney , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Boyd","sequence":"additional","affiliation":[{"name":"Westmead Private Cardiology , Westmead ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Vo","sequence":"additional","affiliation":[{"name":"Westmead Private Cardiology , Westmead ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Byth","sequence":"additional","affiliation":[{"name":"Research and Education Network, Western Sydney Local Health District, Westmead Hospital , Sydney ,","place":["Australia"]},{"name":"NHMRC Clinical Trials Centre, University of Sydney. 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