{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T17:33:40Z","timestamp":1793208820759,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anthracycline cardiotoxicity is often silent at the subclinical stage. Left ventricular ejection fraction (LVEF) detects injury late, and global longitudinal strain (GLS) is sensitive but usually used alone. This study aimed to develop and internally validate a baseline model combining speckle\u2010tracking GLS, conventional echocardiography, and clinical factors to identify women at high risk of subclinical myocardial dysfunction before doxorubicin (DOX) chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a single\u2010center prospective study, 200 breast cancer patients scheduled for DOX\u2010based chemotherapy underwent baseline and 1\u2010month assessment. The primary outcome was subclinical myocardial dysfunction, defined as &gt; 15% relative GLS reduction with preserved LVEF.\n                      <jats:bold>\n                        <jats:italic>P<\/jats:italic>\n                        &lt; 0.10 variables\n                      <\/jats:bold>\n                      in univariable analysis entered multivariable logistic regression for nomogram construction. Discrimination, calibration, and decision curve analysis used 1000\u2010bootstrap validation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Subclinical myocardial dysfunction occurred in 60 of 200 patients (30.0%). Independent predictors were baseline GLS, LDL\u2010C, trastuzumab use, planned cumulative dose, LAVI, and hypertension. The model reached an AUC of 0.803, higher than baseline GLS, a clinical\u2010only model, and baseline LVEF. The bootstrap\u2010corrected C\u2010index was 0.777.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A baseline nomogram combining GLS, conventional echocardiography, and clinical factors may help identify patients at high risk of early subclinical myocardial dysfunction before chemotherapy, outperforming single parameters and supporting risk\u2010stratified monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70637","type":"journal-article","created":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T16:37:01Z","timestamp":1791131821000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of a Predictive Model for Subclinical Myocardial Dysfunction in Breast Cancer Patients Receiving Doxorubicin\u2010Based Chemotherapy: Integrating 2D Speckle Tracking Echocardiography and Conventional Echocardiographic Parameters"],"prefix":"10.1111","volume":"43","author":[{"given":"Sujing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Ultrasound Medicine Suining County People's Hospital  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[{"name":"The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University  Danyang Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine Suining County People's Hospital  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Oncology Suining County People's Hospital  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery Suining County People's Hospital  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine Suining County People's Hospital  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieli","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Echocardiography Affiliated Hospital of Xuzhou Medical University  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-025-04795-4"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxics13040277"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac244"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59050953"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph18101530"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.15805"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.020"},{"issue":"1","key":"e_1_2_11_10_1","first-page":"49","article-title":"Machine Learning for Cardio\u2010Oncology: Predicting Global Longitudinal Strain From Conventional Echocardiographic Measurements in Cancer Patients","volume":"11","author":"Anzai T.","year":"2025","journal-title":"Cardiooncology"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.029465"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.62347\/WPUW2205"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7594"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.11.003"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12122914"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-45733-x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1707889"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-022-01734-3"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15030986"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.15190\/d.2025.16"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1101585"},{"issue":"5","key":"e_1_2_11_22_1","first-page":"689","article-title":"Lipid Metabolism and Breast Cancer: A Narrative Review of the Prognostic Implications and Chemotherapy\u2010Induced Dyslipidemia","volume":"15","author":"Faur I. 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