{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T07:26:26Z","timestamp":1776929186752,"version":"3.51.2"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T00:00:00Z","timestamp":1493337600000},"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":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anthracycline use is limited by cardiotoxicity, including arrhythmias and left ventricular (LV) dysfunction. We aim to characterize the association between electrophysiological changes and LV dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was conducted, including all 147 pediatric cancer survivors at our institution over 18 years of age and treated with an anthracycline. One hundred thirty\u2010four patients who had at least one electrocardiogram (ECG) and echocardiogram were analyzed. The association between dysfunction and baseline characteristics, treatment history, and electrocardigraphic parameters were analyzed using multivariable logistic regression. Additionally, a longitudinal generalized estimating equation (GEE) model was used to examine the temporal association between repeated measure corrected QT (QTc) intervals and subsequent LV function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our population, 24% of patients had LV dysfunction. The initial posttreatment QTc interval was longer in patients with LV dysfunction (438 \u00b1 35 vs. 420 \u00b1 20 msec, <jats:italic>P<\/jats:italic> = 0.002). In logistic regression analysis, QTc interval (<jats:italic>P<\/jats:italic> &lt; 0.001) and cumulative radiation dose (<jats:italic>P<\/jats:italic> = 0.027) were associated with LV dysfunction. On ECGs performed prior to evidence of LV dysfunction, the QTc was longer than on ECGs preceding a normal echocardiogram (451 \u00b1 32 msec vs. 423 \u00b1 25 msec, <jats:italic>P<\/jats:italic> &lt; 0.001). Mean time from QTc \u2265 450 msec to evidence of LV dysfunction was 1.8 \u00b1 2.9 years. In the longitudinal GEE model, QTc prolongation was associated with subsequent decreased fractional shortening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among adult survivors of pediatric cancer treated with anthracyclines, prolongation of the QTc interval was associated with subsequent LV dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26556","type":"journal-article","created":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T19:06:49Z","timestamp":1493406409000},"source":"Crossref","is-referenced-by-count":33,"title":["Electrophysiological effects of anthracyclines in adult survivors of pediatric malignancy"],"prefix":"10.1002","volume":"64","author":[{"given":"Timothy M.","family":"Markman","sequence":"first","affiliation":[{"name":"Department of Medicine The Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Ruble","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Pediatric Oncology The Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Loeb","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Pediatric Oncology The Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Pediatric Oncology The Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary S.","family":"Beasley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Pediatric Cardiology The Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Reid","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Pediatric Cardiology The Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Nazarian","sequence":"additional","affiliation":[{"name":"Department of Medicine The Johns Hopkins University  Baltimore Maryland"},{"name":"Department of Epidemiology The Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland"},{"name":"Division of Cardiology Section for Cardiac Electrophysiology The Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Cardiology Section for Cardiac Electrophysiology Hospital of the University of Pennsylvania  Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs181"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-014-0258-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000446374"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013777"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-014-0396-y"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.10.9777"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2013.195"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25651"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24445"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f1190"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0321"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000257382.89910.fe"},{"issue":"2","key":"e_1_2_9_14_1","first-page":"345","article-title":"Acute doxorubicin\u2010induced cardiac arrhythmias during ether anesthesia","volume":"41","author":"Aversano RC","year":"1983","journal-title":"Res Commun Chem Pathol Pharmacol"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.76.4.645"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000899"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200506093522321"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000665"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(18)47666-1"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI115241"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.02.050"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(84)80026-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19931101)72:9<2739::AID-CNCR2820720935>3.0.CO;2-R"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.10.1906"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.43.379"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.5187"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.7830"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000133187.74800.B9"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19800901)46:5<1109::AID-CNCR2820460506>3.0.CO;2-B"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1179\/joc.1996.8.3.232"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/ctrv.1999.0128"},{"key":"e_1_2_9_32_1","unstructured":"Multicenter Automatic Defibrillator Implantation Trial \u2010 Chemotherapy\u2010Induced Cardiomyopathy (MADIT\u2010CHIC).https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02164721"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.26556","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.26556","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T03:36:17Z","timestamp":1696476977000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.26556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,28]]},"references-count":31,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1002\/pbc.26556"],"URL":"https:\/\/doi.org\/10.1002\/pbc.26556","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,28]]},"article-number":"e26556"}}