{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T15:14:39Z","timestamp":1778166879710,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hematopoietic stem cell transplantation (HSCT) exposes patients to cardiovascular stress through inflammation, metabolic disturbances, and prior cardiotoxic therapies. Although overt dysfunction is uncommon early after transplantation, subclinical cardiac adaptation remains poorly defined. Methods: We evaluated early electrical and mechanical cardiac responses after HSCT using integrated electrocardiographic (ECG) and echocardiographic assessment. In this prospective cohort study, patients underwent paired pre-transplant and early post-transplant (3\u20136 months) ECG and comprehensive echocardiography, including tissue Doppler and speckle-tracking analyses of atrial, ventricular, and right heart function. Results: Patients were stratified into multiple myeloma (MM) and non-MM subgroups. ECG voltage increased after HSCT, particularly in MM patients, without changes in left ventricular (LV) mass, geometry, or global systolic indices, suggesting electrical\u2013structural dissociation. Left atrial (LA) reservoir strain decreased despite stable atrial volumes. Diastolic indices showed selective modulation, including a group-time interaction in the lateral e\u2032\/a\u2032 ratio without elevated filling pressures. Subgroup analyses suggested divergent myocardial responses, with numerical global longitudinal strain (GLS) improvement in MM patients and reduced LV deformation and right ventricular (RV) fractional area change in non-MM patients. Conclusions: Early cardiac responses after HSCT were heterogeneous and compartment-specific, supporting multiparametric imaging for detection of subclinical cardiac adaptation.<\/jats:p>","DOI":"10.3390\/diagnostics16101423","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T14:05:46Z","timestamp":1778162746000},"page":"1423","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Divergent Cardiac Adaptation After Hematopoietic Stem Cell Transplantation: A Multimodal Echocardiographic and Electrocardiographic Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1875-2078","authenticated-orcid":false,"given":"\u00c7etin","family":"Alak","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Bursa Uludag University, Bursa 16059, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4991-9830","authenticated-orcid":false,"given":"Fazil \u00c7a\u011fr\u0131","family":"Hunutlu","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Bursa Sehir Training and Research Hospital, University of Health Sciences, Bursa 16250, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1114-6051","authenticated-orcid":false,"given":"Gokhan","family":"Ocakoglu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine, Bursa Uludag University, Bursa 16059, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4160-0471","authenticated-orcid":false,"given":"Nuray","family":"Mammadova","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Bursa Uludag University, Bursa 16059, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeynep","family":"Kumral","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Unye State Hospital, Ordu 52300, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vildan","family":"Ozkocaman","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, Bursa 16059, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9710-134X","authenticated-orcid":false,"given":"Fahir","family":"Ozkalemkas","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, Bursa 16059, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilek","family":"Ye\u015filbursa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Bursa Uludag University, Bursa 16059, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1056\/NEJMra052638","article-title":"Hematopoietic Stem-Cell Transplantation","volume":"354","author":"Copelan","year":"2006","journal-title":"N. 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