Abstract 14672: Exercise Hemodynamic Profiles of Resting and Exercise-Based Definitions of Cancer Therapy-Related Cardiac Dysfunction in Anthracycline-Treated Breast Cancer Survivors
Bibliographic record
Abstract
Introduction: Detection of cancer therapy-related cardiac dysfunction (CTRCD) is a cornerstone of heart failure (HF) risk assessment. However, it is unclear how closely CTRCD definitions reflect typical HF features of reduced exercise tolerance (VO 2 peak) and blunted cardiac reserve. Hypothesis: Standard CTRCD metrics (resting LVEF and GLS) will show poor agreement with reduced VO 2 peak and changes in cardiac reserve following anthracycline chemotherapy (AC). Methods: This analysis used baseline (pre-AC) and 12-month assessments from a randomized trial of exercise training in breast cancer patients (n=104) undergoing AC ± anti-HER2 therapy. Assessments included resting echocardiography (LVEF and GLS), cardiopulmonary exercise testing (VO 2 peak) and exercise cardiac magnetic resonance (peak cardiac output [CO], stroke volume [SV] and LVEF [LVEF peak ]). CTRCD was defined as ≥10% absolute decline in LVEF to a value <50%, >15% decline in GLS, and a ≥10% decline in VO 2 peak from pre-AC. Results: Seventy-nine participants (76%) completed pre-AC and 12-month assessments, 14 of whom (18%) met LVEF and 30 (38%) met GLS CTRCD criteria (10% met both criteria). In addition to declines in resting LVEF and GLS, these participants showed a reduction in LVEF peak , but no change in peak SV, CO or VO 2 peak (Figure 1A-B). In contrast, 19 participants (24%) had a ≥10% VO 2 peak decline (-17% vs Pre-AC, P<0.001) that coincided with a decline in peak SV (-6%, P=0.03), and LVEF peak (-11%, P=0.02), with no significant change in resting LVEF or GLS (Figure 1C). Of those who met VO 2 peak criteria, only three (16%) and five (26%) met LVEF or GLS criteria, respectively, and only one met all three criteria. Conclusions: Whilst capturing reduced global LV systolic function, CTRCD definitions are insensitive to meaningful declines in VO 2 peak and cardiac reserve. Incorporating measures of VO 2 peak into CTRCD surveillance may improve HF risk stratification in breast cancer survivors.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".