Early Prediction of Cardiotoxicity From Cancer Chemotherapy ― Can Baseline Strain Identify High-Risk Patients? ―

morbidity in cancer survivors is frequently from the cumulative, dose-dependent, irreversible myocyte necrosis caused by anthracyclines (type 1 cardiotoxicity).Furthermore, additional targeted receptor therapy with the monoclonal antibody trastuzumab may alter myocardial repair gene expression, which is reversible once the drug is withdrawn (type 2 cardiotoxicity).Historically, several definitions of cardiotoxicity have been proposed.5 The most commonly used definition is ≥5% reduction in left ventricular ejection fraction (LVEF) from baseline to <55% in symptomatic patients (or ≥10% S urvival after cancer has greatly increased in the past few decades through advances in chemotherapy, as well as surgery, radiotherapy, and diagnostic imaging.Anthracyclines are effective and life-saving drugs that serve as the cornerstone of cancer chemotherapy.The current expected 5-to 10-year survival rate of patients with certain cancers, such as hematologic, breast, and childhood cancer, approaches 80%. 1 However, cancer chemotherapy often causes acute and chronic cardiovascular complications.Cardiotoxicity from cancer chemotherapy has become a leading cause of morbidity and mortality in cancer survivors.2,3 Compared with siblings, cancer survivors are 10-fold more likely to develop coronary artery disease and 15-fold more likely to develop heart failure (HF).4 The high cardiac