{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T01:16:21Z","timestamp":1768094181475,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A previous multicenter study showed that longitudinal changes in standard cardiac functional parameters were associated with the development of cardiomyopathy in childhood cancer survivors (CCS). Evaluation of the relationship between global longitudinal strain (GLS) changes and cardiomyopathy risk was limited, largely due to lack of quality apical 2\u2010 and 3\u2010chamber views in addition to 4\u2010chamber view. We sought to determine whether apical 4\u2010chamber longitudinal strain (A4LS) alone can serve as a suitable surrogate for GLS in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A4LS and GLS were measured in echocardiograms with acceptable apical 2\u2010, 3\u2010, and 4\u2010chamber views. Correlation was evaluated using Pearson and Spearman coefficients, and agreement was evaluated with Bland\u2013Altman plots. The ability of A4LS to identify normal and abnormal values compared to GLS as the reference was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among a total of 632 reviewed echocardiograms, we identified 130 echocardiograms from 56 patients with adequate views (38% female; mean age at cancer diagnosis 8.3\u00a0years; mean follow\u2010up 9.4\u00a0years). Correlation coefficients between A4LS and GLS were .89 (Pearson) and .85 (Spearman), with Bland\u2013Altman plot of GLS\u2014A4LS showing a mean difference of \u2212.71\u00a0\u00b1\u00a01.8. Compared with GLS as the gold standard, A4LS had a sensitivity of 86% (95% CI 79%\u201393%) and specificity of 82% (69%\u201395%) when using normal range cutoffs and 90% (82%\u201397%) and 70% (58%\u201381%) when using \u00b12 standard deviations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A4LS performs well when compared with GLS in this population. Given the more recent adoption of apical 2\u2010 and 3\u2010chamber views in most pediatric echocardiography laboratories, A4LS is a reasonable stand\u2010alone measurement in retrospective analyses of older study cohorts and echocardiogram biorepositories.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15766","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T01:15:05Z","timestamp":1706922905000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Utility of apical four\u2010chamber longitudinal strain in the assessment of childhood cancer survivors: A multicenter study"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6561-7603","authenticated-orcid":false,"given":"Matthew J.","family":"Mosgrove","sequence":"first","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Children's Medical Center University of Texas Southwestern  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5080-7433","authenticated-orcid":false,"given":"Ritu","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla L.","family":"Stratton","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saro H.","family":"Armenian","sequence":"additional","affiliation":[{"name":"City of Hope  Duarte California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-489X","authenticated-orcid":false,"given":"Aarti","family":"Bhat","sequence":"additional","affiliation":[{"name":"University of Washington Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasey J.","family":"Leger","sequence":"additional","affiliation":[{"name":"University of Washington Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Yang","sequence":"additional","affiliation":[{"name":"University of Washington Seattle Children's Hospital  Seattle Washington USA"},{"name":"Children's National Medical Center George Washington University  Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy M.","family":"Leisenring","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lillian R.","family":"Meacham","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim T.","family":"Sadak","sequence":"additional","affiliation":[{"name":"University of Minnesota Masonic Children's Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4066-8980","authenticated-orcid":false,"given":"Shanti L.","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"University of Minnesota Masonic Children's Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul C.","family":"Nathan","sequence":"additional","affiliation":[{"name":"University of Toronto The Hospital for Sick Children  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Chow","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"},{"name":"University of Washington Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William L.","family":"Border","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"NIH National Cancer Institute.Cancer in Children and Adolescents. 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