What question did this study set out to answer?

To assess the prevalence of subclinical cardiac dysfunction in asymptomatic childhood cancer survivors and its relation to treatment and metabolic risk factors.

January 10, 2026Indian Pediatrics0 citations

Subclinical Cardiac Dysfunction in Childhood Cancer Survivors: Insights from Global Longitudinal Strain and Risk Factor Profiling

SJShweta JainTata Institute of Fundamental Research GSGurpreet SinghRajiv Gandhi Cancer Institute and Research Centre NANeeraj AggarwalKurukshetra University

Key Result

Abnormal global longitudinal strain was present in over 40% of asymptomatic childhood cancer survivors, linked to higher anthracycline exposure and metabolic risk factors.

Key Points

To assess the prevalence of subclinical cardiac dysfunction in asymptomatic childhood cancer survivors and its relation to treatment and metabolic risk factors.
Cross-sectional observational design
Participants included pediatric and young adult childhood cancer survivors
Data collected on cancer history, treatment exposures, and comorbidities
Cardiovascular assessments through history, physical examination, ECG, and 2D-echocardiography with GLS analysis
Over 40% of survivors exhibited abnormal global longitudinal strain
88% had a history of anthracycline exposure
Higher anthracycline doses correlated with cardiac dysfunction
Obesity and dyslipidemia were associated with subclinical cardiac issues

Structured PICO

What is the prevalence of subclinical cardiac dysfunction assessed by global longitudinal strain in asymptomatic childhood cancer survivors, and is it associated with treatment exposure and metabolic risk factors?

Population

456 asymptomatic pediatric and young adult childhood cancer survivors (diagnosed before 18 years of age and completed cancer therapy at least two years prior to enrolment)

Outcome

Subclinical cardiac dysfunction assessed by global longitudinal strain (GLS)surrogate

Over 40% of asymptomatic childhood cancer survivors exhibit subclinical cardiac dysfunction on strain imaging, highlighting the importance of routine echocardiographic surveillance and management of modifiable metabolic risk factors.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

OBJECTIVE: To evaluate subclinical cardiac dysfunction and its association with treatment exposure and metabolic risk factors in a cohort of asymptomatic childhood cancer survivors (CCS). METHODS: In this cross-sectional, observational, single-centre study, pediatric and young adult CCS were evaluated. Eligible participants were diagnosed before 18 years of age and had completed cancer therapy at least two years prior to enrolment. Data on cancer history, treatment exposures, and comorbidities were extracted from electronic medical records. Cardiovascular evaluation included history, physical examination, electrocardiogram, and comprehensive 2D-echocardiography with global longitudinal strain (GLS) analysis. Cumulative anthracycline-equivalent doses (CAE) and radiation exposure to the heart were documented. RESULTS: Out of 456 CCS, anthracycline exposure was noted in 88% [mean (SD) CAE dose: 178.1 (123.2) mg/m CONCLUSION: Abnormal GLS was prevalent in over 40% of asymptomatic CCS. Higher anthracycline exposure and presence of obesity and dyslipidemia were linked with subclinical cardiac dysfunction. These findings underscore the need for routine cardiac surveillance using strain imaging and aggressive management of modifiable risk factors to mitigate long-term cardiovascular morbidity in CCS.

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