Value of GLS and NT-proBNP for prediction of cardiomyopathy in survivors of childhood cancer exposed to cardiotoxic therapy

Survivors of childhood cancer who were exposed to cardiotoxic therapy are at increased risk of developing cardiomyopathy. Analysis among St Jude Lifetime Cohort participants ≥ 5 years from diagnosis, with an LVEF ≥ 50% on baseline echocardiography evaluated global longitudinal strain (GLS) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) at inclusion for prediction of future cardiomyopathy risk. Among the included survivors, 11.1% developed ≥ grade 2 cardiomyopathy during median 5.1 years follow-up. The 5-year cumulative incidence of cardiomyopathy was 7.3% in the group with abnormal GLS versus 4.4% in the group without abnormal GLS, and was 9.9% in the group with abnormal NT-proBNP versus 4.7% in the group without abnormal NT-proBNP. Six years after baseline, AUCs for individual risk prediction were 0.70 for models with and 0.63 for models without GLS and NT-proBNP (p=0.022). The authors conclude that GLS and NT-proBNP should be considered for improved identification of survivors at high risk for future cardiomyopathy.