Longitudinal Assessment of Cardiac Function After Craniospinal Irradiation in Pediatric Central Nervous System Tumor Survivors
Authors' conclusion
Progressive long-term decline in systolic function was observed in CSI-treated CNS tumor survivors despite modest cardiac radiation exposure. Age, sex, and endocrine comorbidities influence cardiac trajectories, supporting longitudinal cardiac surveillance.
Study context
- Population
- Pediatric patients diagnosed with a primary CNS tumor treated with craniospinal irradiation (CSI) between January 2000 and September 2024
- Participants
- 129 survivors
- Exposure
- Longitudinal echocardiographic measures of systolic and diastolic function following CSI
- Outcome
- LVEF and LVSF
Main finding
As reported in the abstract
- Left ventricular ejection fraction (LVEF) declined progressively
- P = 0.006
- LV shortening fraction (LVSF) declined progressively
- P < 0.001
- LVSF <28%
- 14 individuals
Observational data: associations, not effects.
Further findings
Diastolic parameters
- Diastolic parameters remained stable
Global longitudinal strain (GLS) (assessed in 100 patients)
- Early post-CSI improvement followed by progressive decline
- P < 0.001
- GLS <16%
- 5 patients
Predictors of cardiac dysfunction
- Older age at diagnosis associated with greater decline in LVEF and LVSF
- Endocrine comorbidities correlated with lower LVEF as attained age increased
- GLS trajectories differed by sex, with lower values in younger females
Original publication
Longitudinal Assessment of Cardiac Function After Craniospinal Irradiation in Pediatric Central Nervous System Tumor Survivors. JACC Adv. Published 15 June 2026. doi:10.
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