Background: Anthracycline-based chemotherapy is highly effective in breast cancer treatment but is limited by dose-dependent cardiotoxicity. Early identification of subclinical myocardial injury is crucial to prevent progression to irreversible dysfunction. Objectives: To evaluate whether a multimodal surveillance strategy integrating left ventricular global longitudinal strain (LVGLS), left atrial reservoir strain (LASr), and high-sensitivity troponin I (hs-TnI) can predict early anthracyclineinduced cardiotoxicity. Methods: This retrospective cohort study included 50 female breast cancer patients (mean age 49.3 ± 8.5 years) treated between January 2022 and December 2024. Echocardiography and biomarkers were assessed at baseline and 1 month after chemotherapy. Cardiotoxicity was defined as a > 10% reduction in LVEF to < 53%. Results: Cardiotoxicity occurred in 15 patients (30%). LVGLS, LASr, and hs-TnI significantly changed (all P < 0.001).Independent predictors were LVGLS (aOR 1.33), LASr (aOR 0.77), and hs-TnI (aOR 1.07). hs-TnI showed the highest discriminative ability (AUC 0.940). Conclusions LVGLS, LASr, and hs-TnI provide complementary information for early detection of cardiotoxicity.

Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV- 2) and has resulted in increased mortality worldwide. Several studies have identified the involvement of the gastrointestinal tract, respiratory tract, and other tissues. Although it has been reported that the angiotensin-converting enzyme-2 receptor affected by SARS-CoV is expressed more in the pancreas than in the lungs, the issue regarding the occurrence of pancreatitis is controversial. SARS Cov-2 rarely causes acute necrotizing pancreatitis without significantly affecting the respiratory and other systems. This paper presents a patient who underwent laparotomy due to acute necrotizing pancreatitis and hemodynamic instability caused by COVID-19 without any known risk factors.

Purpose: The aim of this study was to evaluate the associations of sonographic and sonoelastographic parameters with clinical cardiac parameters, as well as to assess their value in predicting survival in patients with pulmonary arterial hypertension (PAH). Methods: Thirty-six patients with PAH and normal liver function were prospectively enrolled in this prospective study along with 26 healthy controls, all of whom underwent ultrasound and point shear wave elastography examinations. Additionally, the portal vein pulsatility index (PVPI), inferior vena cava collapsibility index, and clinical cardiac variables were obtained in PAH patients. The values of hepatic (LVs) and splenic shear wave velocity (SVs) were compared between PAH patients and controls. The relationships between all sonographic and clinical parameters in the PAH patients were analyzed. Furthermore, their prognostic value in predicting survival was investigated. Results: LVs values in PAH patients (median, 1.62 m/s) were significantly higher than in controls (median, 0.99 m/s), while no significant difference was observed in SVs values. Patients with higher grades of tricuspid regurgitation (TR) had significantly different values of PVPI (P=0.010) and sonoelastographic parameters (P<0.001 for LVs and P=0.004 for SVs) compared to those with less severe TR. Tricuspid annular plane systolic excursion values were the only investigated parameter found to be associated with survival (hazard ratio, 0.814; 95% confidence interval, 0.694 to 0.954; P=0.011). Conclusion Our results demonstrated a direct association between cardiac congestion (i.e., the severity of TR) and liver stiffness, which should be kept in mind during the assessment of fibrosis in patients with PAH.