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CMR imaging biosignature of cardiac involvement due to cancer-related treatment by T1 and T2 mapping

Citation

Haslbauer, JD and Lindner, S and Valbuena-Lopez, S and Zainal, H and Zhou, H and D'Angelo, T and Pathan, F and Arendt, CA and Bug, G and Serve, H and Vogl, TJ and Zeiher, AM and Carr-White, G and Nagel, E and Puntmann, VO, CMR imaging biosignature of cardiac involvement due to cancer-related treatment by T1 and T2 mapping, International Journal of Cardiology, 275 pp. 179-186. ISSN 0167-5273 (2019) [Refereed Article]

Copyright Statement

2018 Elsevier B.V. All rights reserved.

DOI: doi:10.1016/j.ijcard.2018.10.023

Abstract

Background: Cancer-related treatment is associated with development of heart failure and poor outcome in cancer-survivors. T1 and T2 mapping by cardiovascular magnetic resonance (CMR) may detect myocardial injury due to cancer-related treatment.

Methods: Patients receiving cancer-related treatment regimes underwent screening of cardiac involvement with CMR, either within 3 months (early Tx) or >12 months (late Tx) post-treatment. T1 and T2 mapping, cardiac function, strain, ischaemia-testing, scar-imaging and serological cardiac biomarkers were obtained.

Results: Compared to age/gender matched controls (n = 57), patients (n = 115, age (yrs): median(IQR) 48(28-60), females, n = 60(52%) had reduced left ventricular ejection fraction (LV-EF) and strain, and higher native T1 and T2. The early Tx group (n = 52) had significantly higher native T1, T2 and troponin levels compared to the late Tx group, indicating myocardial inflammation and oedema (p < 0.01). On the contrary, late Tx patients showed raised native T1, increased LV-end-systolic volumes, reduced LV-EF and deformation, and elevated NT-proBNP, suggesting myocardial fibrosis and remodelling (p < 0.05). Prospective validation of these results in an independent cohort of patients with similar treatment regimens (n = 25) and longitudinal assessments revealed high concordance of CMR imaging signatures of early and late cardiac involvement.

Conclusions: Native T1 and T2 mapping can be valuable in detecting and monitoring of cardiac involvement with cancer-related treatment, providing distinct biosignatures of early inflammatory involvement (raised native T1 and T2) and interstitial fibrosis and remodelling (raised native T1 but not T2), respectively. Our findings may provide an algorithm allowing to identify susceptible myocardium to potentially guide cardio-protective treatment measures.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
UTAS Author:Pathan, F (Dr Faraz Pathan)
ID Code:131607
Year Published:2019
Web of Science® Times Cited:6
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-03-26
Last Modified:2020-03-10
Downloads:0

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