{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:04Z","timestamp":1787018104008,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,7,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Childhood cancer survivors (CCSs) show relevant cardiac morbidity and mortality throughout life. Early detection is key for optimal support of patients at risk. The aim of this study was to evaluate 2\u2010dimensional speckle\u2010tracking echocardiography strain analysis during semisupine exercise stress in CCSs for detection of subclinical left ventricular dysfunction after cancer treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Seventy\u2010seven CCSs \u22651\u2010year postchemotherapy were prospectively examined at rest, low, and submaximal stress level and compared with a cohort of healthy adolescents and young adults (n=50). Global longitudinal strain (GLS), short axis circumferential strain, and corresponding strain rates were analyzed using vendor\u2010independent software. CCSs at median 7.8\u2009years postchemotherapy showed comparable left ventricular GLS, circumferential strain, and strain rate values at all stress stages to healthy controls. Yet, prevalence of abnormal GLS (defined as &lt;2\u2009SD of controls reference) in CCSs was 1.3% at rest, 2.7% at low, and 8.6% at submaximal stress. In CCSs, relative change of circumferential strain from rest to submaximal stress was lower than in healthy controls, median 16.9 (interquartile range [IQR], 3.4; 28.8) % versus 23.3 (IQR, 11.3; 33.3) %,\n                      <jats:italic>P<\/jats:italic>\n                      =0.03, most apparent in the subgroups of CCSs after high\u2010dose anthracycline treatment and cancer diagnosis before the age of 5\u2009years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this prospective 2\u2010dimensional speckle tracking echocardiography strain study, prevalence of abnormal left ventricular GLS increased with stress level reflecting impaired cardiac adaptation to exercise stress in some CCSs. However, relatively early after last chemotherapy, this did not result in significant differences of mean GLS\u2010, circumferential strain\u2010, and strain rate values between CCSs and controls at any stress level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.025324","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T05:59:22Z","timestamp":1657691962000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-0862","authenticated-orcid":false,"given":"Fabian","family":"von Scheidt","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Pleyer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9050-2228","authenticated-orcid":false,"given":"Verena","family":"Kiesler","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bride","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Bartholomae","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7095-6540","authenticated-orcid":false,"given":"Michael","family":"Kaestner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6780-8077","authenticated-orcid":false,"given":"Christian","family":"Apitz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital University of Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4606"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn310"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20352"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu192"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1203-8"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.04.013"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.119.008869"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20016"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25328"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2019.12.015"},{"key":"e_1_3_2_12_2","unstructured":"Long\u2010term follow\u2010up guidelines for survivors of childhood adolescent and young adult cancers version 5.0. 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