Cardiac MRI: a Translational Imaging Tool for Characterizing Anthracycline-Induced Myocardial Remodeling.

Cardiac MRI: a Translational Imaging Tool for Characterizing Anthracycline-Induced Myocardial Remodeling.
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心脏MRI:一种用于表征蒽环类诱导心肌重塑的翻译成像工具。

DOI:
10.1007/s11912-016-0533-x
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发表时间:
2016-08
影响因子:
4.7
通讯作者:
Chen JJ
Chen JJ
中科院分区:
医学2区
文献类型:
--
作者:
Nguyen KL;Hu P;Ennis DB;Shao J;Pham KA;Chen JJ

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继发于癌症治疗的心血管副作用是癌症幸存者发病率和死亡率的主要原因。蒽环类抗生素(AC)作为许多抗癌治疗策略的支柱,但剂量依赖性心肌损伤限制了它们的使用。累积AC暴露可破坏心肌微结构的动态平衡,而重复损伤和修复导致肌细胞损失、间质性心肌纤维化和收缩力受损。虽然儿童被认为有更大的心肌可塑性,AC暴露在较年轻的年龄预示着更差的预后。在老年患者中,一旦发生心血管疾病,总生存率较低。由于心肌结构中的畸变使心脏易于功能下降,因此使用灵敏的成像工具进行早期检测至关重要,并且对资源利用的影响是巨大的。作为一种综合成像方式,心脏磁共振(CMR)成像能够超越射血分数和心肌变形的量化,以表征对心肌组织健康至关重要的自适应微结构和微血管变化。在此,我们将CMR描述为一种已建立的平移成像工具,可用于临床表征AC相关心肌重塑。
Cardiovascular side effects secondary to cancer therapeutics are the leading causes of morbidity and mortality in cancer survivors. Anthracyclines (AC) serve as the backbone of many anti-cancer treatment strategies, but dose-dependent myocardial injury limits their use. Cumulative AC exposure can disrupt the dynamic equilibrium of the myocardial microarchitecture while repeated injury and repair leads to myocyte loss, interstitial myocardial fibrosis, and impaired contractility. Although children are assumed to have greater myocardial plasticity, AC exposure at a younger age portends worse prognosis. In older patients, there is lower overall survival once they develop cardiovascular disease. Because aberrations in the myocardial architecture predispose the heart to a decline in function, early detection with sensitive imaging tools is crucial and the implications for resource utilization are substantial. As a comprehensive imaging modality, cardiac magnetic resonance (CMR) imaging is able to go beyond quantification of ejection fraction and myocardial deformation to characterize adaptive microstructural and microvascular changes that are important to myocardial tissue health. Herein, we describe CMR as an established translational imaging tool that can be used clinically to characterize AC-associated myocardial remodeling.
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