Fig. 1

Impaired cardiac function in patients with elevated C-reactive protein levels after radiotherapy therapy for cancer. Transthoracic Doppler echocardiography at rest and at immediately post-exercise was used to measured left ventricular ejection fraction (Panel a), mitral annulus early diastolic velocity for myocardial relaxation (Panel b), and the change in left-ventricular outflow tract velocity time integral cardiac output (Panel c) with exercise as a measure of cardiac reserve. Subjects with elevated C-reactive protein (CRP) levels showed significantly worse impairments in cardiac systolic and diastolic function. Abbreviations: LVEF = left-ventricular ejection fraction; hsCRP = high-sensitivity C-reactive protein; e’ = early diastolic mitral annular velocities averaged between the lateral and septal annulus; ∆ LVOT VTI CO = delta left-ventricular outflow tract velocity time integral cardiac output with exercise