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Cancer Therapy-Related Cardiac Dysfunction: Pooled Incidence of Subclinical and Clinical Presentations Using
Mohamad Altamimi1,2, Elfatih A Hasabo1,2, Ammar Elgadi3
1Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland.
Journal of Clinical Medicine
|June 26, 2026
Summary
Cancer therapy-related cardiac dysfunction (CTRCD) affects about a quarter of patients, with significant variation. Longitudinal global longitudinal strain (GLS) decline is a key indicator, appearing before left ventricular ejection fraction (LVEF) changes.
Area of Science:
- Cardiology
- Oncology
- Medical Imaging
Background:
- Cancer therapies can cause cardiac dysfunction, impacting patient outcomes.
- Early detection of cancer therapy-related cardiac dysfunction (CTRCD) is crucial for management.
- Serial assessment of cardiac function is vital during cancer treatment.
Purpose of the Study:
- To determine the pooled incidence of CTRCD.
- To analyze longitudinal changes in global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF).
- To compare echocardiography and cardiac magnetic resonance (CMR) for serial cardiac assessment.
Main Methods:
- Systematic review and meta-analysis of observational studies.
- Pooled incidence estimation of CTRCD.
- Meta-regression and longitudinal cohort comparisons of GLS and LVEF.
- Exploratory subgroup analyses comparing echocardiography and CMR.
Main Results:
- Pooled CTRCD incidence was 27%, with significant heterogeneity.
- GLS worsened more significantly in CTRCD cohorts compared to non-CTRCD cohorts.
- GLS and LVEF deteriorated over time in CTRCD patients; GLS decline preceded LVEF changes.
- No significant association between baseline GLS/LVEF and CTRCD event rates.
- Limited comparative data between echocardiography and CMR.
Conclusions:
- CTRCD affects approximately 25% of patients, with variable estimates.
- Serial GLS monitoring is valuable for early CTRCD detection.
- Baseline GLS and LVEF are not strong predictors of CTRCD incidence.
- Further research is needed to directly compare echocardiography and CMR for CTRCD surveillance.
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