The asymptomatic progression of chemotherapy-induced cardiotoxicity poses a significant risk to breast cancer patients. In the present single-center cohort study, a predictive model for evaluating the risk of cardiotoxicity during or by the end of chemotherapy was designed. The risk-prediction nomogram was delineated and assessed. In total, 34 patients out of 120 developed asymptomatic cardiotoxicity (28.3%). Of six explored biomarkers, only B-type natriuretic peptide showed a reliable pattern of incremental increase, revealing statistical significance between cardiotoxicity “+” and “−” groups by visit 4 or by the 9th month of monitoring (p 0.006). The following predictors were included in the model: age, hypertension, diabetes mellitus, baseline glomerular filtration rate, 6 min walk test measured at visit 4, BNP values at visit 4, left ventricular ejection fraction levels at visit 4, a total dose of radiotherapy received, and anthracycline cumulative doses. The model’s AUC was 0.72 (95% CI 0.59; 0.86), evidencing the satisfactory predictive ability of the model; sensitivity 100% (95% CI 90.36; 100.0) at a specificity of 66.67% (95% CI 50.33; 79.79); PPV 54.1% [95% CI 47.13; 60.91]; PVN 100% [95% CI 94.64; 100.00]. The calibration plot showed satisfactory agreement between predicted and actual chances (p = 0.98). The designed model can be applied in settings lacking speckle tracking echocardiography.

Background: Cardiac surveillance during cancer therapy has traditionally focused on the left ventricle, although the right ventricle (RV) may also be affected. Objective: To appraise and synthesize systematic reviews of echocardiographic RV changes during predominantly anthracycline-containing cancer therapy. Methods: This registered umbrella review (PROSPERO CRD420261461273) followed PRIOR and the relevant principles of PRISMA 2020. Five databases were searched, supplemented by backward and forward citation searching. Methodological quality, review-level risk of bias, certainty of evidence, and primary-study overlap were assessed using AMSTAR 2, ROBIS, an adapted GRADE framework, and the Corrected Covered Area (CCA), respectively. Results: Four systematic reviews with meta-analyses (2022–2025) were included, comprising 76 primary-study occurrences representing 40 unique studies. AMSTAR 2 confidence was critically low and ROBIS overall risk of bias was unclear for all four reviews. Primary-study overlap was very high (CCA = 30.0%). RV global longitudinal strain (RVGLS) and free-wall longitudinal strain (RVFWLS) showed the most consistent group-level changes; where mean differences were reported, pooled declines were approximately 1.0–3.2 percentage points. Conventional, hemodynamic and volumetric measures changed less consistently or were sparsely reported. Certainty of evidence was very low for all evaluated outcomes. Conclusions: RV strain remains a candidate marker of treatment-associated RV changes. However, concordance across overlapping reviews does not represent independent replication, the changes cannot be attributed specifically to anthracyclines, and whether they exceed measurement variability is unknown. Prospective studies with appropriate comparators, standardized serial RV imaging and patient-important outcomes are needed.

Background/Objectives: The HFA-ICOS baseline cardiovascular risk classification was developed to standardize pretreatment risk stratification before potentially cardiotoxic cancer therapy, but its external performance across diverse populations remains incompletely characterized. We prospectively evaluated its performance in women with breast cancer receiving anthracycline-containing therapy in Central Asia. Methods: This prospective single-center external validation study used data from the PREDICATE cohort (ISRCTN12628444). Participants were classified at baseline as being at low, moderate, high, or very high cardiovascular risk according to the HFA-ICOS classification before treatment and outcome ascertainment; the high- and very-high-risk categories were pooled for analysis because of small numbers. Participants underwent serial cardiovascular surveillance, including echocardiographic assessment of left ventricular ejection fraction and global longitudinal strain, together with serial cardiac biomarker measurements. The primary outcome was cancer therapy-related cardiac dysfunction (CTRCD), defined according to the 2022 ESC cardio-oncology criteria. Results: The analysis included 108 participants. CTRCD occurred in 43 of 108 participants (39.8%). The observed proportion of participants who developed CTRCD increased from 30.0% in the low-risk group to 47.5% in the moderate-risk group and 75.0% in the high/very-high-risk group (p = 0.026). Kaplan–Meier analysis demonstrated significant separation of CTRCD-free survival across HFA-ICOS risk categories (log-rank χ² = 10.12; p = 0.006). Compared with the low-risk group, the hazard of CTRCD was higher in the moderate-risk group (hazard ratio [HR], 2.16; 95% confidence interval [CI], 1.13–4.13) and high/very-high-risk group (HR, 3.59; 95% CI, 1.42–9.11). Discrimination was modest (area under the curve, 0.630; 95% CI, 0.530–0.724). Conclusions: The HFA-ICOS classification demonstrated a clear ordinal gradient in CTRCD risk and significant time-to-event separation but showed limited discrimination at the individual-patient level. It may guide initial risk stratification but should be complemented by longitudinal cardiovascular surveillance rather than used as a stand-alone predictor.

Chemotherapy-induced endothelial damage is a complex issue characterized by cardiovascular toxicity and cellular injury. This study aims to analyze primary research areas related to chemotherapy-induced endothelial dysfunction, focusing on countries, institutions, journals, authors, and keywords. Methods. The research employs a descriptive bibliometric design to collect and analyze data from 3,430 publications indexed in the Web of Science and Scopus databases, spanning the years 1994-2024. The bibliometric analysis includes English-language research articles and review papers examining endothelial dysfunction in chemotherapy patients. Data analysis was conducted using RStudio and the Bibliometrix R package, with VOSviewer utilized for visualization. Results. The annual publication trend reveals fluctuations, peaking in 2005 while showing sustained interest in recent years. The United States leads in publication volume with 1,328 articles, closely followed by China and Japan. High levels of international collaboration were noted, particularly between the United States and European countries. Key contributing institutions include Harvard Medical School in the USA and the National Cancer Institute, while prominent authors such as Wang and Kim make significant contributions to the field. "Cancer Research" is recognized as one of the most influential journals, highlighting the interdisciplinary relevance of this field. Conclusions. This bibliometric analysis highlights the evolving key research trends related to angiogenesis, VEGF inhibitors, and the need to increase international cooperation. Given the recent introduction of new classes and groups of chemotherapeutic drugs into practice and the growing body of knowledge in this area, a renewed surge of interest in this topic can be anticipated.