{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:06:28Z","timestamp":1791378388851,"version":"4.3.2"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T00:00:00Z","timestamp":1488153600000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005633","name":"Syd\u00e4ntutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003125","name":"Suomen Kulttuurirahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005431","name":"Pirkanmaan Rahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005431","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008723","name":"Suomen L\u00e4\u00e4ketieteen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008723","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Increased cardiovascular morbidity and mortality are major late complications after radiotherapy (<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>) in the thoracic region. Ultrasound tissue characterization (<jats:styled-content style=\"fixed-case\">UTC<\/jats:styled-content>) is a noninvasive method for the identification of myocardial changes. The aim of this prospective clinical trial was to assess whether the analysis of cyclic variation of integrated backscatter (<jats:styled-content style=\"fixed-case\">CVIBS<\/jats:styled-content>) can detect early <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>\u2010induced myocardial alterations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010three eligible patients with early\u2010stage breast cancer were evaluated before and immediately after adjuvant <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>. Twenty and 53 patients had right\u2010sided and left\u2010sided breast cancer, respectively. None of the patients received chemotherapy. Comprehensive echocardiographic examination included three\u2010dimensional (3D) measurements and <jats:styled-content style=\"fixed-case\">UTC<\/jats:styled-content> analysis of the left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) septum and posterior wall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> reduced <jats:styled-content style=\"fixed-case\">CVIBS<\/jats:styled-content> in a dose\u2010dependent manner. The mean heart radiation dose over two gray (Gy) reduced the septal <jats:styled-content style=\"fixed-case\">CVIBS<\/jats:styled-content> from 12.0\u00b13.4 to 9.6\u00b12.5 <jats:styled-content style=\"fixed-case\">dB<\/jats:styled-content> (<jats:italic>P<\/jats:italic>&lt;.001) and the posterior wall <jats:styled-content style=\"fixed-case\">CVIBS<\/jats:styled-content> from 12.8\u00b12.7 to 11.3\u00b12.4 <jats:styled-content style=\"fixed-case\">dB<\/jats:styled-content> (<jats:italic>P<\/jats:italic>=.007). The <jats:styled-content style=\"fixed-case\">CVIBS<\/jats:styled-content> remained unchanged when the mean heart <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> dose was below 2\u00a0Gy. Multivariate analysis showed an independent association with a change in septal <jats:styled-content style=\"fixed-case\">CVIBS<\/jats:styled-content> and the use of aromatase inhibitor (\u03b2=2.986, <jats:italic>P<\/jats:italic>=.001) and body mass index (\u03b2=\u22120.241, <jats:italic>P<\/jats:italic>=.014). The posterior values were worse with higher mean lung dose (\u03b2=\u2010.485, <jats:italic>P<\/jats:italic>=.018) and with nonsmoking status (\u03b2=\u22122.411, <jats:italic>P<\/jats:italic>=.009). Echocardiography parameters showed increased myocardial mass but conventional measurements of the <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> systolic function remained unchanged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cyclic variation of integrated backscatter analysis seems to be a sensitive method to detect early <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>\u2010induced myocardial changes. Hence, it may be useful in screening of patients needing closer follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13433","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T10:45:29Z","timestamp":1488192329000},"page":"191-198","source":"Crossref","is-referenced-by-count":4,"title":["Detection of early radiotherapy\u2010induced changes in intrinsic myocardial contractility by ultrasound tissue characterization in patients with early\u2010stage breast cancer"],"prefix":"10.1111","volume":"34","author":[{"given":"Suvi Sirkku","family":"Tuohinen","sequence":"first","affiliation":[{"name":"Heart Center Co. 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