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Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer 

  • Authors:
    • Jieqiong Zhao
    • Xiao Wang
    • Xiaoxue Liu
    • Wei Zhao
    • Xia Lu
    • Ruijie Li
    • Xiang Sun
  • View Affiliations / Copyright

    Affiliations: Department of Ultrasound, Functional Department, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050000, P.R. China, Second Department of Oncology, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050000, P.R. China, Department of Rehabilitation, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050000, P.R. China, Pharmacy of Traditional Medicine, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050000, P.R. China, Third Department of Neurology, Xinle Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050799, P.R. China, Second Department of Encephalopathy, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050000, P.R. China
    Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 101
    |
    Published online on: February 9, 2026
       https://doi.org/10.3892/etm.2026.13097
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Abstract

Patients with small cell lung cancer (SCLC) may develop heart failure after chemotherapy; therefore, it is crucial to explore the factors that affect the occurrence of heart failure. The present study retrospectively collected data from 550 patients with SCLC who received chemotherapy. Analysis of differences between groups (patients with and without heart failure, as well as patients with different severities of heart failure) was performed on demographic characteristics and cardiac biomarkers, followed by multivariate and multinomial logistic regression analyses on factors that were found to be significantly different in the intergroup analysis, to screen for factors that significantly influence heart failure. Finally, receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of combined indicators for the occurrence and severity of heart failure. Multivariate logistic regression analysis initially identified the cumulative dose of chemotherapy drugs, cardiac troponin I (cTnI), N‑terminal pro‑B‑type natriuretic peptide, left ventricular ejection fraction (LVEF) and creatine kinase‑myocardial band as independent prognostic factors of heart failure. Multinomial logistic regression analysis showed that both cTnI and LVEF had significant effects in predicting the severity of heart failure. ROC curve analysis demonstrated that a cTnI level ≥0.044 ng/ml and LVEF ≤39.083% could predict the occurrence of heart failure, whereas a cTnI level ≥0.059 ng/ml and LVEF ≤37.216% were associated with moderate‑to‑severe heart failure. The standardized combination indicators (cTnI and LVEF) also showed strong predictive ability (AUC >0.75). In conclusion, the present study demonstrated that cTnI, LVEF and their combination may serve as independent prognostic factors for predicting the occurrence and severity of heart failure in patients with SCLC after chemotherapy. These findings suggest that cTnI and LVEF should be routinely monitored during the early stages of chemotherapy for identifying patients at high risk for heart failure and early intervention, ultimately improving patient prognosis.
View Figures

Figure 1

ROC curve evaluation of the ability of
cTnI to predict heart failure. The ability of cTnI to predict the
occurrence of (A) mild heart failure, (B) moderate-to-severe heart
failure and (C) life-threatening heart failure or death. ROC,
receiver operating characteristic.

Figure 2

ROC curve evaluation of the ability of
LVEF to predict heart failure. The ability of LVEF to predict the
occurrence of (A) mild heart failure, (B) moderate-to-severe heart
failure and (C) life-threatening heart failure or death. ROC,
receiver operating characteristic.

Figure 3

ROC curve evaluation of the ability of
the combined indicator to predict heart failure. The ability of
cTnI and LVEF combined to predict the occurrence of (A) mild heart
failure, (B) moderate-to-severe heart failure and (C)
life-threatening heart failure or death. ROC, receiver operating
characteristic.
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Copy and paste a formatted citation
Spandidos Publications style
Zhao J, Wang X, Liu X, Zhao W, Lu X, Li R and Sun X: Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer . Exp Ther Med 31: 101, 2026.
APA
Zhao, J., Wang, X., Liu, X., Zhao, W., Lu, X., Li, R., & Sun, X. (2026). Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer . Experimental and Therapeutic Medicine, 31, 101. https://doi.org/10.3892/etm.2026.13097
MLA
Zhao, J., Wang, X., Liu, X., Zhao, W., Lu, X., Li, R., Sun, X."Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer ". Experimental and Therapeutic Medicine 31.4 (2026): 101.
Chicago
Zhao, J., Wang, X., Liu, X., Zhao, W., Lu, X., Li, R., Sun, X."Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer ". Experimental and Therapeutic Medicine 31, no. 4 (2026): 101. https://doi.org/10.3892/etm.2026.13097
Copy and paste a formatted citation
x
Spandidos Publications style
Zhao J, Wang X, Liu X, Zhao W, Lu X, Li R and Sun X: Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer . Exp Ther Med 31: 101, 2026.
APA
Zhao, J., Wang, X., Liu, X., Zhao, W., Lu, X., Li, R., & Sun, X. (2026). Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer . Experimental and Therapeutic Medicine, 31, 101. https://doi.org/10.3892/etm.2026.13097
MLA
Zhao, J., Wang, X., Liu, X., Zhao, W., Lu, X., Li, R., Sun, X."Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer ". Experimental and Therapeutic Medicine 31.4 (2026): 101.
Chicago
Zhao, J., Wang, X., Liu, X., Zhao, W., Lu, X., Li, R., Sun, X."Analysis of independent prognostic factors for the occurrence and severity of heart failure after chemotherapy in patients with small cell lung cancer ". Experimental and Therapeutic Medicine 31, no. 4 (2026): 101. https://doi.org/10.3892/etm.2026.13097
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