Native myocardial T1 time can predict development of subsequent anthracycline-induced cardiomyopathy.
Native myocardial T1 time can predict development of subsequent anthracycline-induced cardiomyopathy.
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DOI：
10.1002/ehf2.12277
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发表时间：
2018-08
影响因子：
3.8
通讯作者：
Schulz-Menger J
中科院分区：
文献类型：
--
作者：
Muehlberg F;Funk S;Zange L;von Knobelsdorff-Brenkenhoff F;Blaszczyk E;Schulz A;Ghani S;Reichardt A;Reichardt P;Schulz-Menger J
本研究旨在评估蒽环类药物治疗早期功能和形态心肌磁共振参数的亚临床变化，这可能预测蒽环类药物诱导的心肌病（aCMP）的后续发展。招募了30例计划进行蒽环类化疗（360-400 mg/m2阿霉素当量）的肉瘤患者。中位治疗时间为19.1 ± 2.1周。入组的个人接受了三项心血管磁共振研究（治疗前、首次蒽环类药物治疗后48小时和治疗完成后）。除常规心血管磁共振和1.5 T稳态自由旋进电影成像外，还采集了自然T1标测（改良Look-Raw反转恢复5s（3s）3s）、T2标测和细胞外容积标测。患者给予0.2 mmol/kg钆特醇进行细胞外容积定量和晚期钆增强成像。相关aCMP的发展定义为左心室射血分数（LVEF）下降> 10%。为了进行分析，提供了23个完整的数据集。9例患者发生aCMP，LVEF降低>10%，直至化疗结束。有和无后续aCMP的患者之间的基线LVEF无差异。在首次服用抗环素类药物后48 h，发生继发性aCMP的患者的自体心肌T1时间（1002.0 ± 37.9 vs. 956.5 ± 29.2 ms，P < 0.01）显著低于未发生aCMP的患者（990.9 ± 56.4 vs. 978.4 ± 57.4 ms，P > 0.05）。aCMP患者在治疗结束后左心室质量下降（86.9 ± 24.5 vs. 81.1 ± 22.3 g; P = 0.02），而无aCMP患者左心室质量无变化（81.8 ± 21.0 vs. 79.2 ± 18.1 g; P > 0.05）。所有患者在化疗期间均未出现新的心肌瘢痕或致密心肌纤维化。首次蒽环类药物治疗后48小时T1的早期下降可以预测化疗完成后后续aCMP的发展。
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). Thirty sarcoma patients with planned anthracycline‐based chemotherapy (360–400 mg/m2 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. Early decrease of T1 times 48 h after first treatment with anthracyclines can predict the development of subsequent aCMP after completion of chemotherapy.
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DOI：
10.1007/s10554-017-1235-7
发表时间：
2018-01
期刊：
The international journal of cardiovascular imaging
影响因子：
--
作者：
Piechnik SK;Jerosch-Herold M
通讯作者：
Jerosch-Herold M
影响因子：
4
作者：
Kitayama, Hiromitsu;Kondo, Tomohiro;Tsuji, Yasushi
通讯作者：
Tsuji, Yasushi
影响因子：
18.2
作者：
Daugaard, G;Lassen, U;Kjaer, A
通讯作者：
Kjaer, A
影响因子：
7.5
作者：
Schmacht, Luisa;Traber, Julius;Schulz-Menger, Jeanette
通讯作者：
Schulz-Menger, Jeanette
影响因子：
2.8
作者：
Neilan, Tomas G.;Coelho-Filho, Otavio R.;Jerosch-Herold, Michael
通讯作者：
Jerosch-Herold, Michael