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Background. Childhood cancer survivors treated with anthracyclines and mediastinal irradiation are at risk for late onset cardiotoxicity. Aims of the Study. To assess the role of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and tissue Doppler imaging (TDI) as early predictors of late onset cardiotoxicity in asymptomatic survivors of childhood cancer treated with doxorubicin with or without mediastinal irradiation. Methods. A cross‐sectional study on 58 asymptomatic survivors of childhood cancer who received doxorubicin in their treatment protocols and 32 asymptomatic Hodgkin’s lymphoma survivors who received anthracycline and mediastinal irradiation. Levels of NT‐proBNP, TDI, and conventional echocardiography were determined. Results. Thirty percent of survivors had abnormal NT‐proBNP levels. It was significantly related to age at diagnosis, duration of follow‐up, and cumulative dose of doxorubicin …