Detecting subclinical cardiotoxicity during immune checkpoint inhibitor therapy: a combined GLS and ECG repolarization analysis

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dc.contributor.authorOkşen, Doğaç
dc.contributor.authorGeçit, Muhammed Heja
dc.contributor.authorArslan, Şükrü
dc.contributor.authorAslan, Muzaffer
dc.contributor.authorYavuz, Yunus Emre
dc.contributor.authorSeçmeler, Şaban
dc.contributor.authorOktay, Veysel
dc.date.accessioned2025-08-14T13:59:21Z
dc.date.available2025-08-14T13:59:21Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractPurpose: Immune checkpoint inhibitors (ICIs) can induce subclinical cardiac dysfunction that often goes undetected by conventional monitoring. This study evaluated whether echocardiographic global longitudinal strain (GLS) and electrocardiographic (ECG) repolarization parameters could detect early, subclinical cardiotoxicity in patients with cancer and without pre-existing cardiovascular disease undergoing ICI therapy. Methods: A observational cohort study included 74 patients with cancer treated with ICIs between January 2023 and August 2024. Echocardiographic GLS measurements and detailed ECG analyses were performed at baseline and repeated at 6 months. Cardiotoxicity was defined as a significant reduction in GLS or left ventricular ejection fraction. Correlations between GLS and ECG repolarization parameters were statistically assessed. Results: At 6 months, significant subclinical myocardial impairment was observed, with GLS decreasing from 19.40 ± 1.07% to 17.70 ± 1.62% (p<0.001). Notable ECG changes included increased QT dispersion (40.10 ± 10.55 ms to 50.20 ± 15.30 ms, p=0.001), QTc prolongation (420.45 ± 20.60 ms to 430.75 ± 25.40 ms, p=0.013), increased Tp-e interval (80.21 ± 10.45 ms to 85.30 ± 12.40 ms, p=0.021), and elevated heart rate (72.21 ± 8.40 bpm to 75.35 ± 9.15 bpm, p=0.037). GLS was negatively correlated with QT dispersion (r = -0.845, p < 0.05) and Tp-e intervals (r = -0.478, p = 0.052). Conclusion: GLS and ECG repolarization parameters, particularly QT dispersion and Tp-e intervals, effectively detect subclinical myocardial dysfunction in patients with cancer undergoing ICI therapy. These findings underscore the importance of comprehensive cardiac monitoring to enable early intervention and mitigate cardiotoxicity risk during immunotherapy.
dc.identifier.citationOksen, D., Gecit, M. H., Arslan, S., Aslan, M., Yavuz, Y. E., Secmeler, S., & Oktay, V. (2025). Detecting subclinical cardiotoxicity during immune checkpoint inhibitor therapy: a combined GLS and ECG repolarization analysis. Frontiers in Oncology, 15, 1615209. 10.3389/fonc.2025.1615209
dc.identifier.doi10.3389/fonc.2025.1615209
dc.identifier.pmid40697379
dc.identifier.scopus2-s2.0-105011351882
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://hdl.handle.net/20.500.12939/5843
dc.identifier.volume15
dc.identifier.wosWOS:001533323700001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakPubMed
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.institutionauthorOkşen, Doğaç
dc.institutionauthorSeçmeler, Şaban
dc.language.isoen
dc.publisherFrontiers Research Foundation
dc.relation.ispartofFrontiers in Oncology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectcardio-oncology
dc.subjectcardiotoxicity
dc.subjectglobal longitudinal strain
dc.subjectimmune checkpoint inhibitors
dc.subjectrepolarization abnormalities
dc.titleDetecting subclinical cardiotoxicity during immune checkpoint inhibitor therapy: a combined GLS and ECG repolarization analysis
dc.typeArticle

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