{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T02:26:34Z","timestamp":1768789594381,"version":"3.49.0"},"reference-count":46,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2013,2,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To determine the prevalence of pulmonary hypertension, a late effect of cancer therapy not previously identified in aging survivors of childhood cancer, and associations with chest-directed radiation therapy (RT) and measures of current cardiac function, lung function, and exercise capacity. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Cross-sectional evaluation of 498 survivors at a median age of 38.0 years (range, 20.0 to 59.0 years) and a median of 27.3 years (range, 12.2 to 46.0 years) from primary cancer diagnosis was performed. Abnormal tricuspid regurgitant jet velocity (TRV) was defined as more than 2.8 m\/s by Doppler echocardiography. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Increased TRV was identified in 25.2% of survivors who received chest-directed RT and 30.8% of those who received more than 30 Gy. In multivariable models, increased TRV was associated with increasing dose of RT (1 to 19.9 Gy: odds ratio [OR], 2.09; 95% CI, 0.63 to 6.96; 20 to 29.9 Gy: OR, 3.46; 95% CI, 1.59 to 7.54; \u2265 30 Gy: OR, 4.54; 95% CI, 1.77 to 11.64 compared with no RT; P for trend &lt; .001), body mass index more than 40 kg\/m<jats:sup>2<\/jats:sup> (OR, 3.89; 95% CI, 1.46 to 10.39), and aortic valve regurgitation (OR, 5.85; 95% CI, 2.05 to 16.74). Survivors with a TRV more than 2.8 m\/s had increased odds (OR, 5.20; 95% CI, 2.5 to 11.0) of severe functional limitation on a 6-minute walk compared with survivors with a TRV \u2264 2.8 m\/s. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> A substantial number of adult survivors of childhood cancer who received chest-directed RT have an increased TRV and may have pulmonary hypertension as a result of both direct lung injury and cardiac dysfunction. Longitudinal follow-up and confirmation by cardiac catheterization are warranted. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2012.43.0702","type":"journal-article","created":{"date-parts":[[2013,1,8]],"date-time":"2013-01-08T22:42:27Z","timestamp":1357684947000},"page":"774-781","source":"Crossref","is-referenced-by-count":26,"title":["Increased Tricuspid Regurgitant Jet Velocity by Doppler Echocardiography in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study"],"prefix":"10.1200","volume":"31","author":[{"given":"Gregory T.","family":"Armstrong","sequence":"first","affiliation":[{"name":"Gregory T. Armstrong, Liang Zhu, Deokumar Srivastava, Nan Zhang, Kirsten K. Ness, Matthew T. Krasin, Leslie L. Robison, Melissa M. Hudson, and Daniel M. Green, St Jude Children's Research Hospital; and Vijaya M. Joshi, Dennis C. Stokes, and James A. 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