Cardiovascular Magnetic Resonance in Early Detection of Radiation Associated Cardiotoxicity With Chest Radiation.
Cardiovascular Magnetic Resonance in Early Detection of Radiation Associated Cardiotoxicity With Chest Radiation.
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DOI：
10.3389/fcvm.2022.867479
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发表时间：
2022
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
--
作者：
胸部放射治疗（RT）已知与心脏毒性有关。然而，放射性心脏毒性引起的心肌组织特征的变化还不清楚。本研究旨在使用心血管磁共振（CMR）评估接受RT患者的左心室功能和组织表征的变化。2015年6月至2018年7月，我们招募了计划在化疗后接受胸部放疗的乳腺癌、肺癌或淋巴瘤患者。在基线和RT后6个月使用1.5T扫描仪进行CMR。使用非参数方法测量和比较心肌体积、功能、使用特征跟踪的应变分析和组织表征，包括晚期钆增强（LGE）、T1、T2、T1ρ（rho）和细胞外容积分数（ECV）。最终队列包括16例患者，其中11例完成了基线和随访CMR。患者与10名健康对照者相匹配。在RT之前的基线，与对照组相比，患者的整体周向应变（GCS）较低（15.3 ± 2.2% vs.18.4 ± 2.1%，p = 0.004）和T2升高（47.9 ± 4.8 ms vs. 45.0 ± 1.5 ms，p = 0.04）和T1ρ值（78.4 ± 5.9 vs. 66.9 ± 4.6 ms，p < 0.001）。2例患者发生LGE。平均T1值或ECV无显著差异。LV射血分数和整体纵向应变（GLS）有降低的趋势。RT后6个月随访时，所有CMR参数均无显著变化。在胸部放疗后6个月，在一个小型患者队列中，LV和RV EF、LV和RV GLS、LV GCS和使用LGE、T1、ECV、T2和T1ρ进行的心肌组织表征无变化。然而，与对照组相比，基线T2和T1ρ升高，LV GCS降低，表明化疗后持续心肌水肿和亚临床功能障碍。
Chest radiation therapy (RT) is known to be associated with cardiotoxicity. However, the changes in myocardial tissue characterization with radiation-induced cardiotoxicity are not well-understood. This study sought to assess the changes in left ventricular function and tissue characterization using cardiovascular magnetic resonance (CMR) in patients receiving RT. Between June 2015 and July 2018, we enrolled patients with breast, lung cancer, or lymphoma with plan to receive chest radiation after chemotherapy. CMR was performed using a 1.5T scanner at baseline and 6 months after RT. Myocardial volume, function, strain analysis using feature tracking, and tissue characterization including late gadolinium enhancement (LGE), T1, T2, T1ρ (rho), and extracellular volume fraction (ECV) were measured and compared using non-parametric methods. The final cohort consisted of 16 patients, 11 of whom completed both baseline and follow-up CMRs. Patients were matched to 10 healthy controls. At baseline prior to RT, compared to controls, patients had lower global circumferential strain (GCS) (15.3 ± 2.2% vs.18.4 ± 2.1%, p = 0.004), and elevated T2 (47.9 ± 4.8 ms vs. 45.0 ± 1.5 ms, p = 0.04) and T1ρ values (78.4 ± 5.9 vs. 66.9 ± 4.6 ms, p < 0.001). Two patients had LGE. There was no significant difference in the average T1 values or ECV. There was a trend toward lower LV ejection fraction and global longitudinal strain (GLS). At 6-month follow-up after RT, there were no significant changes in all the CMR parameters. At 6-month following chest radiation therapy, there was no change in LV and RV EF, LV and RV GLS, LV GCS, and myocardial tissue characterization using LGE, T1, ECV, T2, and T1ρ in a small cohort of patients. However, the baseline T2 and T1ρ were elevated and LV GCS was reduced compared to controls indicating ongoing myocardial edema and subclinical dysfunction post-chemotherapy.
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影响因子：
6.2
作者：
Delaney, G;Jacob, S;Barton, M
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Barton, M
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Schulz-Menger J
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Schmitt, Matthias