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| Item Type: | Article |
|---|---|
| Title: | Native myocardial T1 time can predict development of subsequent anthracycline-induced cardiomyopathy |
| Creators Name: | Muehlberg, F., Funk, S., Zange, L., von Knobelsdorff-Brenkenhoff, F., Blaszczyk, E., Schulz, A., Ghani, S., Reichardt, A., Reichardt, P. and Schulz-Menger, J. |
| Abstract: | Aims: This study aims to assess subclinical changes in functional and morphological myocardial magnetic resonance parameters very early into an anthracycline treatment, which may predict subsequent development of anthracycline-induced cardiomyopathy (aCMP). Methods and results: Thirty sarcoma patients with planned anthracycline-based chemotherapy (360-400 mg/m doxorubicin-equivalent) were recruited. Median treatment time was 19.1 ± 2.1 weeks. Enrolled individuals received three cardiovascular magnetic resonance studies (before treatment, 48 h after first anthracycline treatment, and upon completion of treatment). Native T1 mapping (modified Look-Locker inversion recovery 5s(3s)3s), T2 mapping, and extracellular volume maps were acquired in addition to a conventional cardiovascular magnetic resonance with steady-state free precession cine imaging at 1.5 T. Patients were given 0.2 mmol/kg gadoteridol for extracellular volume quantification and late gadolinium enhancement imaging. Development of relevant aCMP was defined as drop of left ventricular ejection fraction (LVEF) by >10%. For analysis, 23 complete data sets were available. Nine patients developed aCMP with LVEF reduction >10% until end of chemotherapy. Baseline LVEF was not different between patients with and without subsequent aCMP. When assessed 48 h after first dose of antracyclines, patients with subsequent aCMP had significantly lower native myocardial T1 times compared with before therapy (1002.0 ± 37.9 vs. 956.5 ± 29.2 ms, P < 0.01) than patients who did not develop aCMP (990.9 ± 56.4 vs. 978.4 ± 57.4 ms, P > 0.05). Patients with aCMP had decreased left ventricular mass upon completion of therapy (86.9 ± 24.5 vs. 81.1 ± 22.3 g; P = 0.02), while patients without aCMP did not show a change in left ventricular mass (81.8 ± 21.0 vs. 79.2 ± 18.1 g; P > 0.05). No patient developed new myocardial scars or compact myocardial fibrosis under chemotherapy. Conclusions: Early decrease of T1 times 48 h after first treatment with anthracyclines can predict the development of subsequent aCMP after completion of chemotherapy. |
| Keywords: | Anthracyclines, Cardiomyopathy, T1 Mapping, Cardiac MR, Cardiovascular MR, Cardiotoxicity |
| Source: | ESC Heart Failure |
| ISSN: | 2055-5822 |
| Publisher: | Wiley-Blackwell |
| Volume: | 5 |
| Number: | 4 |
| Page Range: | 620-629 |
| Date: | August 2018 |
| Official Publication: | https://doi.org/10.1002/ehf2.12277 |
| PubMed: | View item in PubMed |
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