Abstract 9402: Diffuse Myocardial Fibrosis Negatively Correlates with Exercise Capacity in Children with Subclinical Anthracycline Cardiotoxicity
Bibliographic record
Abstract
Background The effectiveness of anthracycline chemotherapy in improving survival is limited by late cardiotoxicity. The aim of this study was to examine novel cardiac MRI and echocardiography measures to detect subclinical cardiotoxicity in childhood cancer survivors, and to determine its relationship to exercise capacity. Methods Thirty patients (15±3years, 50% male), 8±5 years after anthracycline therapy (cumulative dose 197±84 mg/m 2 ), underwent cardiac MRI, echocardiography and cardiopulmonary (cycle ergometer) exercise testing (VO 2peak ). Cardiac MRI assessed volumetric function, mass, and myocardial extra-cellular volume (ECV), a measure of diffuse fibrosis based on changes in blood and myocardial T1 values pre and post gadolinium. Tissue Doppler annular velocities (E’, A’) and peak circumferential and longitudinal strain, strain rate (SR) and torsion, from speckle tracking, were compared to 35 healthy controls (13±4 years). Data (mean ± SD) was analysed using Pearson's product-moment coefficient and unpaired t-tests (p<0.05). Results Patients were asymptomatic with normal LVEF (59±7%) but VO 2peak was 15% lower than age and gender determined healthy predicted values. Myocardial ECV was inversely correlated with mass/volume ratio (r = -0.5, p<0.01), and VO 2peak (r = -0.5, p<0.01), and lower VO 2peak correlated with increased cumulative dose (r = 0.4, p<0.05). Echocardiographic measures of systolic function were significantly reduced compared to controls (decreased circumferential and longitudinal strain, longitudinal SR and torsion, p<0.01). Diastolic dysfunction was evident with decreased circumferential and longitudinal diastolic SR and decreased annular velocities (p<0.01) relative to controls. There was no correlation between echocardiographic parameters and ECV or VO 2peak . Conclusion Diffuse myocardial fibrosis (increased ECV) is correlated with reduced mass/volume ratios and VO 2peak in children post anthracyline. While there were abnormalities of systolic and diastolic function, these metrics did not correlate with ECV or VO 2peak . Myocardial ECV provides a non-invasive early marker of ventricular remodelling that is related to exercise capacity which may be of prognostic value in childhood 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 | 0.000 | 0.001 |
| 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".