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Contemporary guidelines stress early detection using multimodal approaches, including echocardiographic global longitudinal strain (GLS) and cardiac biomarkers, yet real-world adoption is inconsistent. 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13(36): 114228  \nDOI: 10.12998/wjcc.v13.i36.114228 ISSN 2307-8960 (online)  \nEDITORIAL  \nChemotherapy-related cardiotoxicity: Bridging the gap between evidence and practice  \nWajid Ali, Aimen Mehmood, Salim Surani  \nSpecialty type: Medicine, general and internal  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade A, Grade B, Grade B  \nNovelty: Grade B, Grade B, Grade B  \nCreativity or Innovation: Grade B, Grade B, Grade B  \nScientific Significance: Grade A, Grade B, Grade B  \nP-Reviewer: Elbarbary MA, Assistant Professor, Consultant, Egypt; Gutiérrez-Cuevas J, PhD, Professor, Mexico; Shafik MS, Lecturer, Egypt  \nReceived: September 17, 2025  \nRevised: October 29, 2025  \nAccepted: December 22, 2025  \nPublished online: December 26, 2025  \nProcessing time: 102 Days and 9.1 Hours  \nWajid Ali, Department of Medicine, Harlem Hospital Center, New York, NY 10037, United States  \nAimen Mehmood, Department of Medicine, University of Cincinnati, Cincinnati, OH 45221, United States  \nSalim Surani, Department of Medicine, University of Houston, College Station, TX 77004, United States  \nCorresponding author: Salim Surani, MD, Department of Medicine, University of Houston, 40 Bizzell Street, College Station, TX 77004, [United States.](United States. srsurani@hotmail.com)[ srsurani@hotmail.com](United States. srsurani@hotmail.com)  \nAbstract  \nChemotherapy-related cardiac dysfunction (CTRCD) remains a major barrier to optimal cancer survivorship, threatening quality of life and long-term outcomes. Contemporary guidelines emphasize early detection through multimodal strategies, including echocardiographic global longitudinal strain (GLS) and cardiac biomarkers, but their real-world uptake is inconsistent. In this issue, Méndez-Toro et al present a retrospective cohort from Colombia that highlights this gap, reporting a CTRCD incidence of 8.8% in high-risk oncology patients. Although the authors observed clear declines in left ventricular ejection fraction and GLS among affected patients, less than 40% underwent end-of-treatment echocardiography and only one-quarter had biomarker surveillance. The study underscores three critical lessons: Multimodal monitoring is under-utilized, reported incidence likely underestimates the true burden, and low-and middle-income countries face unique challenges in implementing structured cardio-oncology programs. These findings demand a shift from sporadic monitoring to pragmatic, risk-adapted protocols that can translate early detection into meaningful cardioprotection.  \nKey Words: Cardio-oncology; Chemotherapy-related cardiac dysfunction; Global longitudinal strain; Biomarkers; Echocardiography; Cancer survivorship; Low- and middle-income countries; Multimodal monitoring  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJCC  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 26, 2025  Volume 13  Issue 36   \nAli W et al. Bridging gap between evidence and practice  \nCore Tip: This study shows that chemotherapy-related cardiotoxicity is underestimated when multimodal surveillance is inconsistently applied. Cardio-oncology must now move beyond sporadic imaging and biomarkers toward structured, riskadapted protocols, particularly in low-and middle-income countries where there is a high incidence of global cancer care.  \nCitation: Ali W, Mehmood A, Surani S. Chemotherapy-related cardiotoxicity: Bridging the gap between evidence and practice. World J Clin Cases 2025; 13(36): 114228  \nURL: [https://www.wjgnet.com/2307-8960/full/v13/i36/114228.htm](https://www.wjgnet.com/2307-8960/full/v13/i36/114228.htm)  \nDOI: [https://dx.doi.org/10.12998/wj","cbCaioP6d8HvsoQE","https://ap.wps.com/l/cbCaioP6d8HvsoQE","pdf",406675,"English","# Abstract\n# Introduction\n## Cardiotoxicity and CTRCD as late effects\n## Key cardiotoxic agents and mechanisms\n## Rationale for early multimodal detection","[{\"question\":\"What problem does the article address regarding chemotherapy-related cardiotoxicity?\",\"answer\":\"The article highlights that chemotherapy-related cardiac dysfunction remains a major barrier to cancer survivorship, with early detection approaches not consistently used in practice.\"},{\"question\":\"Which monitoring methods do guidelines recommend for early CTRCD detection?\",\"answer\":\"Guidelines recommend multimodal strategies, including echocardiographic global longitudinal strain (GLS) and serial cardiac biomarkers, alongside conventional left ventricular ejection fraction (LVEF).\"},{\"question\":\"What does the reported study from Colombia show about real-world surveillance?\",\"answer\":\"The study reports a CTRCD incidence of 8.8% in high-risk oncology patients and shows that fewer than 40% received end-of-treatment echocardiography, with only one-quarter undergoing biomarker surveillance.\"}]","Chemotherapy-related cardiotoxicity - Bridging the gap between evidence and practice | PDF",1790568237,15]