Early subclinical myocardial, vascular and endothelial dysfunction in cancer patients treated with immune checkpoint inhibitors

Clicks: 1
ID: 323319
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #166 of 282 articles by views in European heart journal supplements : journal of the European Society of Cardiology

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 282 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Immune checkpoint inhibitors (ICIs) have significantly improved cancer outcomes; however, immune-mediated cardiovascular toxicity is increasingly recognized. Data on early subclinical myocardial, vascular and microvascular effects of ICIs remains limited. Purpose To evaluate early changes in myocardial deformation, arterial stiffness, endothelial glycocalyx integrity and coronary microvascular function in patients receiving ICIs. Methods Adult cancer patients initiating ICI therapy were prospectively enrolled. Comprehensive cardiovascular assessment was performed at baseline and at 6-month follow-up and included: i) global left ventricular longitudinal strain (GLS) by speckle-tracking imaging, ii) myocardial global work efficiency (GWE) by left ventricular longitudinal strain - noninvasive brachial artery pressure loops, iii) carotid femoral pulse wave velocity (PWV) and central systolic blood pressure (Complior ALAM), iv) coronary flow reserve (CFR) by Doppler echocardiography, v) perfused boundary region (PBR) of the sublingual arterial microvessels, with increasing PBR indicating reduced endothelial glycocalyx thickness (Microscan, Glycocheck), Results Thirty-six patients (mean age 65 years, 58% male) were included. Most patients were treated with PD-1 inhibitors (69%), while 31% received PD-L1 inhibitors. Lung cancer was the most frequent malignancy (39%), followed by gastrointestinal (19%), renal (17%), and other malignancies. Left ventricular ejection fraction remained preserved during follow-up (56.3±5.1% vs 55.7±5.4%, p=0.07). In contrast, GLS deteriorated significantly (from −18.4±2.9% to −16.6±2.8%, p<0.01), accompanied by a reduction in myocardial GWE (from 94.4±2.3% to 92.5±2.7%, p<0.01). Arterial stiffness worsened (PWV increased from 12.2±2.1 to 12.8±2.2 m/s, p=0.008), and coronary microvascular function declined, with CFR decreasing from 2.48±0.27 to 2.35±0.26 (p<0.01). Endothelial glycocalyx integrity deteriorated (PBR increased from 2.17±0.29 to 2.25±0.30, p=0.005). During one-year follow-up, six non-cardiovascular deaths, one pulmonary embolism, one immune-related myositis and one myocardial infarction were recorded. Conclusion ICI therapy is associated with early subclinical myocardial deformation impairment, arterial stiffening, endothelial glycocalyx impairment and coronary microvascular dysfunction, despite preserved ejection fraction. These findings support systematic cardiovascular surveillance and prevention in patients receiving immune checkpoint inhibitors.
Reference Key
openalex_W7172272615 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors E Karamanolis, K Katogiannis, J Thymis, E Zazas, D Vlachomitros, A Psyrri, I Ikonomidis, G Filippatos, D Farmakis
Journal European heart journal supplements : journal of the European Society of Cardiology
Year 2026
DOI
10.1093/eurheartjsupp/suag097.019
URL
https://doi.org/10.1093/eurheartjsupp/suag097.019
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.