Cardio-oncology & otherCohort study
Early anthracycline cardiotoxicity in adolescents and young adults with sarcoma: a prospective echocardiographic study
- prospective echocardiographic study
- single tertiary cancer centre
- echocardiograms interpreted by a single cardiologist
Authors' conclusion
Over one-third of AYAs with sarcoma met the primary endpoint at 1 year, with half of these abnormalities persisting at 2 years, primarily driven by LVWT/D ratio reductions. Subclinical changes in strain and diastolic function were observed, reflecting the broad cardiac impact of high-dose Dox in this population.
Study context
- Population
- Adolescents and young adults (15–39 years) with sarcoma treated with high-dose doxorubicin at a tertiary cancer centre (2018–22)56 completed at least two of three study echocardiograms
- Participants
- 70 adolescents
- Outcome
- >10% absolute reduction in LVEF, an absolute LVEF <50%, or >10% decrease in LVWT/D ratio from baseline
- Follow-up
- 1 and 2 years
Main finding
As reported in the abstract
- Primary endpoint met at 1 year
- 44.4%
- Primary endpoint met at 2 years
- 27.5%
- LVWT/D ratio decline at 1 year
- 37%
- LVWT/D ratio decline at 2 years
- 25%
- Significant left ventricular ejection fraction (LVEF) decline at 1 year
- 11.1%
- Significant LVEF decline at 2 years
- 2.5%
Observational data: associations, not effects.
Secondary outcomes
Baseline characteristics and treatment
- Median age
- 22.6 [IQR, 17.6-30.5] years
- Female
- 41%
- White
- 84%
- Median cumulative doxorubicin (Dox) dose
- 450 (IQR, 370-450) mg/m²
- Received dexrazoxane
- 75%
Absolute changes in echocardiographic measures · 1 year
- LVEF
- −2.73 ± 4.3%, P < .001
- Global longitudinal strain magnitude
- −1.37 ± 2.56%, P = .002
- Septal e′
- −1.75 ± 2.48 cm/s, P < .001
- Lateral e′
- −2.78 ± 3.44 cm/s, P < .001
- persisting at 2 years
Safety
Ventricular fibrillation and heart failure with reduced ejection fraction
- Patients developing ventricular fibrillation and HFrEF
- One patient (1.8%)
- LVEF recovery within 1 year
Original publication
Early anthracycline cardiotoxicity in adolescents and young adults with sarcoma: a prospective echocardiographic study. ESC Heart Fail. Published 19 June 2026. doi:10.1093/eschf/xvag143
Summarised from the published abstract; every number is checked against it