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Lung Cancer Research Studies / Chemotherapy-induced Cardiotoxicity and Mitigation · Journal article
BMC Cardiovascular Disorders · September 7, 2026
Encouraging direction, but not yet definitive.
This retrospective cohort study of 312 cancer patients found that myocardial work parameters—particularly global work index (GWI)—detect left ventricular mechanical dysfunction at interim follow-up before overt ejection fraction decline, with GWI achieving an AUC of 0.817 for predicting subsequent CTRCD diagnosis. The findings suggest MW parameters may enable earlier identification of cardiotoxicity, but the retrospective design and lack of prospective validation limit current clinical implementation.
Retrospective cohort study. 312 patients with malignant tumors (mean age 54.63 ± 10.28 years; 51.28% male) receiving potentially cardiotoxic cancer therapy between January 2023 and November 2025.. Intervention: Potentially cardiotoxic cancer therapy (types and doses not specified in abstract). Compared with: CTRCD diagnosis at endpoint; comparison of myocardial work parameters between CTRCD and non-CTRCD groups at interim follow-up. n = 312. Not specified beyond multicenter implication; published in BMC Cardiovascular Disorders..
At interim follow-up (T1, pre-CTRCD diagnosis), CTRCD patients showed significant reductions in GLS, GWI, and GCW and increased GWW (all p < 0.05), while LVEF decreased only mildly GWI_T1 was an independent correlate of CTRCD with OR = 0.995 (95% CI: 0.993–0.997, p < 0.001) GWI_T1 demonstrated the best predictive value with AUC = 0.817 (95% CI: 0.765–0.869) and optimal cutoff > 2,055 mmHg% yielding sensitivity 71.8% and specificity 76.9%
Mechanism for GWI superiority over GLS and other parameters not explained; clinical outcomes (morbidity, mortality) not assessed
Clinicians managing cancer patients receiving cardiotoxic therapy should recognize that myocardial work parameters, particularly GWI, may enable earlier detection of subclinical cardiac dysfunction than LVEF alone. However, this retrospective finding requires prospective validation and cost-effectiveness analysis before integration into routine cardiotoxicity monitoring protocols.
A retrospective cohort study with adequate sample size and sound methodology demonstrating that myocardial work parameters detect cardiac dysfunction earlier than ejection fraction, but requiring prospective validation and external replication to confirm clinical utility.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians managing cancer patients receiving cardiotoxic therapy should recognize that myocardial work parameters, particularly GWI, may enable earlier detection of subclinical cardiac dysfunction than LVEF alone. However, this retrospective finding requires prospective validation and cost-effectiveness analysis before integration into routine cardiotoxicity monitoring protocols.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This study aimed to investigate the value of myocardial work (MW) parameters for the early identification of cancer therapy-related cardiac dysfunction (CTRCD) in an echocardiographic (ECHO) cohort. This retrospective study included 312 patients with malignant tumors [mean age 54.63 ± 10.28 years; 160 (51.28%) males] who received potentially cardiotoxic cancer therapy between January 2023 and November 2025. Patients were divided into CTRCD ( n = 78) and non-CTRCD groups ( n = 234). Serial ECHO assessments were performed at baseline (T0), interim follow-up (T1), and endpoint (T2). T1 was defined as the follow-up ECHO examination obtained before CTRCD diagnosis and was selected as the examination closest to baseline among available follow-up assessments that did not meet CTRCD diagnostic criteria. Clinical data, treatment-related factors, and ECHO parameters were collected. Global longitudinal strain (GLS) and MW parameters, including global work index (GWI), constructive work (GCW), wasted work (GWW), and work efficiency (GWE), were derived from speckle-tracking and pressure-strain loop analyses. Logistic regression analysis was performed to identify independent correlates of CTRCD. The predictive value of MW parameters for CTRCD was evaluated using receiver operating characteristic curves. At interim follow-up (T1, pre-CTRCD diagnosis), the CTRCD group showed significant reductions in GLS, GWI, GCW, and GWE, along with increased GWW (all p < 0.05), whereas left ventricular ejection fraction (LVEF) decreased only mildly. Non-CTRCD patients had no significant changes. Multivariable analysis identified GLS_T1 ( OR = 1.624, 95% CI: 1.284–2.053), GWI_T1 ( OR = 0.995, 95% CI: 0.993–0.997), GCW_T1 ( OR = 0.997, 95% CI: 0.995–0.998), and GWW_T1 ( OR = 1.016, 95% CI: 1.008–1.024) as independent correlates of CTRCD (all p < 0.001). GWI_T1 demonstrated the best predictive value (AUC = 0.817; 95% CI: 0.765–0.869), with an optimal cutoff of > 2,055 mmHg% yielding a sensitivity of 71.8% and a specificity of 76.9%. MW parameters detect left ventricular mechanical impairment before overt LVEF decline, enabling early CTRCD identification. GWI shows superior predictive discrimination and may enhance cardiotoxicity monitoring in cancer patients.
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