Cardio-oncology & otherCohort study

Longitudinal Assessment of Cardiac Function After Craniospinal Irradiation in Pediatric Central Nervous System Tumor Survivors

JACC AdvPublished

  • retrospective, multi-institutional cohort study

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

Main finding

As reported in the abstract

LVEF and LVSF

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:10.1016/j.jacadv.2026.102886

Summarised from the published abstract; every number is checked against it