{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:48:56Z","timestamp":1787500136673,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,11,12]],"date-time":"2014-11-12T00:00:00Z","timestamp":1415750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surveillance for anthracycline cardiotoxicity in cancer survivors typically utilizes resting M\u2010mode and two\u2010dimensional echocardiography, which are insensitive to detection of subtle myocardial changes. We examined childhood cancer survivors treated with anthracyclines during exercise using various echocardiography techniques to investigate if these tools can better detect subclinical cardiac dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>We recruited asymptomatic survivors at least five years post treatment. Echocardiography was performed at rest and at termination of exercise utilizing tissue Doppler techniques and strain rate imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty participants were characterized by cardiotoxicity risk status (high [12], moderate [23], low [24], no risk [21]) as defined by the Children's Oncology Group Long Term Follow\u2010Up Guidelines v3.0. The high\u2010risk group had a higher resting heart rate than controls (100 vs. 88\u2009bpm [\n                      <jats:italic>P<\/jats:italic>\n                      for trend\u2009=\u20090.049]). Peak aerobic capacity in all groups was similar. Compared to controls at rest, the high\u2010risk group had evidence of diastolic dysfunction with lower E\/A ratios (1.4 vs. 2.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008) and higher septal early diastolic velocities (E\/E') of 11.7 versus 9.9 (\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u20090.165). With exercise, this difference resolved and myocardial contractile reserve was preserved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Asymptomatic, pediatric cancer survivors at high\u2010risk for anthracycline cardiotoxicity have some evidence of diastolic filling abnormalities at rest. With exercise, they augment their systolic and diastolic function to achieve normal maximal aerobic capacity suggesting they are able to compensate for mild cardiac dysfunction in the early years after exposure. Additionally, findings suggest that routine exercise echocardiography may not be a useful surveillance tool to assess anthracycline cardiotoxicity. Pediatr Blood Cancer 2015;62:502\u2013508. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.25328","type":"journal-article","created":{"date-parts":[[2014,11,12]],"date-time":"2014-11-12T14:32:47Z","timestamp":1415802767000},"page":"502-508","source":"Crossref","is-referenced-by-count":44,"title":["Assessing anthracycline\u2010treated childhood cancer survivors with advanced stress echocardiography"],"prefix":"10.1002","volume":"62","author":[{"given":"A. Blythe","family":"Ryerson","sequence":"first","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Border","sequence":"additional","affiliation":[{"name":"Sibley Heart Center Cardiology Atlanta Georgia"},{"name":"Department of Pediatrics Emory University School of Medicine Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Wasilewski\u2010Masker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine Atlanta Georgia"},{"name":"Aflac Cancer &amp; Blood Disorders Center Children's Healthcare of Atlanta Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Meacham","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine Atlanta Georgia"},{"name":"Aflac Cancer &amp; Blood Disorders Center Children's Healthcare of Atlanta Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harland","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann C.","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta Georgia"},{"name":"Department of Pediatrics Emory University School of Medicine Atlanta Georgia"},{"name":"Aflac Cancer &amp; Blood Disorders Center Children's Healthcare of Atlanta Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,12]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"SEER Cancer Statistics Review, 1975\u20132010","author":"Howlader N"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa060185"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6296"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.13.3163"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.13.3173"},{"key":"e_1_2_5_7_1","first-page":"683","article-title":"Late cardiotoxic effects of anthracycline chemotherapy in childhood malignancies","volume":"58","author":"Roodpeyma S","year":"2008","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1542\/peds.89.5.942","article-title":"Guidelines for cardiac monitoring of children during and after anthracycline therapy: Report of the Cardiology Committee of the Childrens Cancer Study Group","author":"Steinherz LJ","year":"1992","journal-title":"Pediatrics"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-99-6-750"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(87)80232-2"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-7120-5-4"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.10.063"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi152"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035153"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000061952.27445.A0"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470120074036"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi143"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.07.029"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-007-0397-6"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2006.04.019"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90173-K"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70008-7"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(76)90021-9"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(97)10007-5"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tox.2007.05.016"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2007.08.002"},{"key":"e_1_2_5_27_1","unstructured":"Children's Oncology Group. 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