{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T03:45:06Z","timestamp":1768967106919,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the effects of cardioprotective therapy (CPT) with neurohormonal inhibitors on cancer therapeutics\u2013related cardiac dysfunction (CTRCD) in breast cancer patients, focusing on right ventricular (RV) function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a secondary analysis of SAFE study, a randomized, phase 3, double\u2010blind, placebo\u2010controlled, four\u2010arm trial, in which the effects of short\u2010term CPT (bisoprolol, ramipril, or both) compared to placebo (P\u2010arm) on subclinical CTRCD were evaluated in 222 women without cardiac risk factors who received intensive anthracycline\u2010based chemotherapy (median isoequivalent doxorubicin dose 288\u00a0mg\/m<jats:sup>2<\/jats:sup>). Among them, 35% received trastuzumab, 98% taxanes, 22% underwent neoadjuvant therapy, 78% adjuvant therapy, and 56% had postoperative radiotherapy. CPT started with chemotherapy and continued for 1 year, or until the completion of trastuzumab therapy. All the patients underwent cardiac surveillance at baseline and 3, 6, 12, and 24 months. Left ventricular CTRCD was assessed following the 2022 ESC guidelines. RV function was evaluated according to established recommendations. RV CTRCD was defined as a greater than 10% reduction in RV fractional area change (FAC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 24 months, LV CTRCD was observed in 42.9% of P\u2010arm and 3.1% of the CPT arms (<jats:italic>p<\/jats:italic> &lt; 0.001). Compared to the CPT arms, there was a significant reduction in RV FAC (\u221210.5%), S\u2019\u2010wave velocity (\u221212.2%), and tricuspid annular plane systolic excursion (\u22129.6%) in the P\u2010arm. Additionally, the RV diameter increased by 7% in the P\u2010arm. RV CTRCD was found in 49.2% of the P\u2010arm and 22% of the CPT arms (<jats:italic>p<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Short\u2010term neurohormonal cardioprotection was effective in reducing RV CTRCD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.70291","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T15:20:37Z","timestamp":1758208837000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Cardioprotection on the Right Ventricular Function in Breast Cancer Patients Receiving Potentially Cardiotoxic Therapy: A SAFE Trial Substudy"],"prefix":"10.1111","volume":"42","author":[{"given":"Maria Riccarda","family":"Del Bene","sequence":"first","affiliation":[{"name":"Diagnostic Cardiology CardioThoracic and Vascular Department Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Icro","family":"Meattini","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Biomedical Sciences \u201cM. Serio\u201d University of Florence  Florence Italy"},{"name":"Radiation Oncology and Breast Unit Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Pilato","sequence":"additional","affiliation":[{"name":"Diagnostic Cardiology CardioThoracic and Vascular Department Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlotta","family":"Becherini","sequence":"additional","affiliation":[{"name":"Radiation Oncology and Breast Unit Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Martella","sequence":"additional","affiliation":[{"name":"Breast and Medical Oncology Units Oncology Department Azienda USL Toscana Centro  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viola","family":"Salvestrini","sequence":"additional","affiliation":[{"name":"Radiation Oncology and Breast Unit Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Marrazzo","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Biomedical Sciences \u201cM. Serio\u201d University of Florence  Florence Italy"},{"name":"Medical Physics Unit Oncology Department Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calogero","family":"Saieva","sequence":"additional","affiliation":[{"name":"Cancer Risk Factors and Lifestyle Epidemiology Unit Institute For Cancer Research Prevention and Clinical Network (ISPRO)  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iacopo","family":"Olivotto","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Barletta","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Livi","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Biomedical Sciences \u201cM. 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