{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:30:06Z","timestamp":1793331006713,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Pharmaceuticals Israel Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The association between anthracycline (ANT) and left ventricle (LV) dysfunction is well known; however, data regarding its direct effect on cardiac valve function is limited. We aimed to evaluate how ANT therapy affected valvular function in patients diagnosed with breast cancer. Data were prospectively collected as part of the Israel Cardio-Oncology Registry (ICOR). Patients underwent echocardiography exams at baseline (T1), during ANT therapy (T2), and after completion within 3 months (T3) and 6 months (T4). A total of 141 female patients were included, with a mean age of 51 \u00b1 12 years. From T1 to T4, we observed a significant deterioration in LV ejection fraction (60.2 \u00b1 1.5 to 59.2 \u00b1 2.7%, p = 0.0004) and LV global longitudinal strain (\u221221.6 (\u221220.0\u2013\u221223.0) to \u221220.0 (\u221219.1\u2013\u221221.1)%, p &lt; 0.0001)), and an increase in LV end-systolic diameter (25 (22\u201327) to 27 (24\u201330) mm, p &lt; 0.0001). We observed a significant increase in the incidence of new mitral regurgitation (MR) development (4 to 19%, p &lt; 0.0001), worsening with concomitant trastuzumab therapy (6% to 31%, p = 0.003), and a trend for tricuspid regurgitation development (4% to 8%, p = 0.19). ANT therapy is associated with the development of a new valvular disease, mainly MR, which may imply the need for a valvular focus in the monitoring of cancer patients.<\/jats:p>","DOI":"10.3390\/life12081275","type":"journal-article","created":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T23:51:01Z","timestamp":1661125861000},"page":"1275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Valvular Heart Disease following Anthracycline Therapy\u2014Is It Time to Look beyond Ejection Fraction?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6887-3348","authenticated-orcid":false,"given":"David","family":"Zahler","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7865-8983","authenticated-orcid":false,"given":"Joshua H.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Medicine, University of Illinois at Chicago, Chicago, IL 60607, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tali","family":"Bar-On","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Internal Medicine T, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Raphael","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Oncology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shafik","family":"Khoury","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zach","family":"Rozenbaum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shmuel","family":"Banai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaron","family":"Arbel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Topilsky","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Laufer-Perl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"220","DOI":"10.3322\/caac.21149","article-title":"Cancer treatment and survivorship statistics, 2012","volume":"62","author":"Siegel","year":"2012","journal-title":"CA Cancer J. 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