{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:46:41Z","timestamp":1792172801715,"version":"4.4.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T00:00:00Z","timestamp":1631923200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T00:00:00Z","timestamp":1631923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>Cancer therapy-related cardiac dysfunction (CTRCD) is a relevant clinical problem and needs early prediction. This study aimed to analyze myocardial injury using serial laboratory and cardiac magnetic resonance imaging (CMR) parameters after epirubicin-based chemotherapy compared with left-sided radiotherapy and to study their value for early prediction of CTRCD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Sixty-six consecutive women (53\u2009\u00b1\u200913\u00a0years) including <jats:italic>n<\/jats:italic>\u2009=\u200939 with epirubicin-based chemotherapy and n\u2009=\u200927 with left-sided radiotherapy were prospectively studied by 3\u00a0T CMR including left ventricular (LV) mass and volumes for ejection fraction (LVEF), as well as feature-tracking with global longitudinal strain (GLS) and T1\/T2 mapping. CMR was performed at baseline, at therapy completion (follow-up 1, FU1), and after 13\u2009\u00b1\u20092\u00a0months (FU2). CTRCD was defined as LVEF decline of at least 10% to\u2009&lt;\u200955% or a\u2009&gt;\u200915% GLS change at FU2.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>T1 and T2 increased at FU1 after epirubicin-based chemotherapy, but not after left-sided radiotherapy. CTRCD occurred in 20% of patients after epirubicin-based chemotherapy and in 4% after left-sided radiotherapy. T1 at FU1 was the best single parameter to predict CTRCD with an area under the curve (AUC) of 0.712 (CI 0.587\u20130.816, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) with excellent sensitivity (100%, 66\u2013100%), but low specificity (44%, 31\u201358%). Combined use of increased T1 and LVEF\u2009\u2264\u200960% at FU1 improved AUC to 0.810 (0.695\u20130.896) resulting in good sensitivity (78%, 44\u201395%) and specificity (84%, 72\u201392%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Only epirubicin-based chemotherapy, but not left-sided radiotherapy, resulted in increased T1\/T2 myocardial relaxation times as a marker of myocardial injury. Combined use of CMR parameters may allow an early prediction of subsequent CTCRD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p>\u2022 <jats:italic>Myocardial T1 and T2 relaxation times increased at FU1 after epirubicin-based chemotherapy, but not after left-sided radiotherapy.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>Cancer therapy\u2013related cardiac dysfunction (CTRCD) occurred in 20% of patients after epirubicin-based chemotherapy and in 4% after left-sided radiotherapy.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>Combined use of increased T1 and reduced LVEF had an AUC of 0.810 (0.695\u20130.896) to predict CTRCD with good sensitivity (78%, 44\u201395%) and specificity (84%, 72\u201392%).<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-021-08260-7","type":"journal-article","created":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T08:02:51Z","timestamp":1631952171000},"page":"1853-1865","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Myocardial injury detected by T1 and T2 mapping on CMR predicts subsequent cancer therapy\u2013related cardiac dysfunction in patients with breast cancer treated by epirubicin-based chemotherapy or left-sided RT"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6999-2787","authenticated-orcid":false,"given":"Enver","family":"Tahir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuella","family":"Azar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Shihada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Seiffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Goy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Beitzen-Heineke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Molwitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Muellerleile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Stehning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Sch\u00f6n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Adam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cordula","family":"Petersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkmar","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar K.","family":"Lund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,18]]},"reference":[{"key":"8260_CR1","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1056\/NEJM199511303332203","volume":"333","author":"B Fisher","year":"1995","unstructured":"Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM (1995) Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. 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The other authors report no conflicts.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Gerhard Sch\u00f6n from the Institute for Medical Biometry and Epidemiology performed the statistical analyses for this paper. He is one of the authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"All participants gave their written informed consent before being included in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The ethics committee of the general medical council approved the study (PV5292).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 prospective\u2022 longitudinal study\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}