{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T20:45:29Z","timestamp":1762980329026,"version":"3.41.2"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,9,21]],"date-time":"2016-09-21T00:00:00Z","timestamp":1474416000000},"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":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>ECG and echocardiography are noninvasive screening tools to detect subclinical cardiotoxicity in childhood cancer survivors (CCSs). Our aims were as follows: (1) assess the prevalence of abnormal ECG patterns, (2) determine the agreement between abnormal ECG patterns and echocardiographic abnormalities; and (3) determine whether ECG screening for subclinical cardiotoxicity in CCSs is justified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We retrospectively studied ECG and echocardiography in asymptomatic CCSs more than 5 years after anthracycline treatment. Exclusion criteria were abnormal ECG and\/or echocardiogram at the start of therapy, incomplete follow\u2010up data, clinical heart failure, cardiac medication, and congenital heart disease. ECG abnormalities were classified using the Minnesota Code. Level of agreement between ECG and echocardiography was calculated with Cohen kappa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 340 survivors with a mean follow\u2010up of 14.5 years (range 5\u201332). ECG was abnormal in 73 survivors (21.5%), with ventricular conduction disorders, sinus bradycardia, and high\u2010amplitude R waves being most common. Prolonged QTc (&gt;0.45 msec) was found in two survivors, both with a cumulative anthracycline dose of 300 mg\/m<jats:sup>2<\/jats:sup> or higher. Echocardiography showed abnormalities in 44 survivors (12.9%), mostly mild valvular abnormalities. The level of agreement between ECG and echocardiography was low (kappa 0.09). Male survivors more often had an abnormal ECG (corrected odds ratio: 3.00, 95% confidence interval: 1.68\u20135.37).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Abnormal ECG patterns were present in 21% of <jats:italic>asymptomatic<\/jats:italic> long\u2010term CCSs. Lack of agreement between abnormal ECG patterns and echocardiographic abnormalities may suggest that ECG is valuable in long\u2010term follow\u2010up of CCSs. However, it is not clear whether these abnormal ECG patterns will be clinically relevant.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26243","type":"journal-article","created":{"date-parts":[[2016,9,21]],"date-time":"2016-09-21T16:02:46Z","timestamp":1474473766000},"source":"Crossref","is-referenced-by-count":14,"title":["Is screening for abnormal ECG patterns justified in long\u2010term follow\u2010up of childhood cancer survivors treated with anthracyclines?"],"prefix":"10.1002","volume":"64","author":[{"given":"Milanthy S.","family":"Pourier","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Radboud University Medical Center Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annelies M. 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M.","family":"B\u00f6kkerink","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Radboud University Medical Center Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nel","family":"Roeleveld","sequence":"additional","affiliation":[{"name":"Department for Health Evidence Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Pediatrics, Radboud University Medical Center Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gil","family":"Beer","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit Tel Aviv University Tel\u2010Aviv Sourasky Medical Centre  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Bellersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Kapusta","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit Tel Aviv University Tel\u2010Aviv Sourasky Medical Centre  Tel Aviv Israel"},{"name":"Children's Heart Centre, Radboud University Medical Center Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,21]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1561","article-title":"Up\u2010to\u2010date monitoring of childhood cancer long\u2010term survival in Europe: methodology and application to all forms of cancer combined","volume":"18","author":"Brenner H","year":"2007","journal-title":"Ann Hematol Oncol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2006.06.006"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17550-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa060185"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2016.01.009"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.13.3163"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.1425"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn310"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4606"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199103213241205"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.12.121"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.4.1544"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70409-7"},{"key":"e_1_2_8_15_1","unstructured":"Richtlijn follow\u2010up na kinderkanker. 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