Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Faron, A; Isaak, A; Mesropyan, N; Reinert, M; Schwab, K; Sirokay, J; Sprinkart, AM; Bauernfeind, FG; Dabir, D; Pieper, CC; Heine, A; Kuetting, D; Attenberger, U; Landsberg, J; Luetkens, JA.
Cardiac MRI Depicts Immune Checkpoint Inhibitor-induced Myocarditis: A Prospective Study
RADIOLOGY. 2021; 301(3): 602-609.
Doi: 10.1148/radiol.2021210814
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Heine Annkristin
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- Abstract:
- Background: Immune checkpoint inhibitors (ICIs) for cancer treatment are associated with a spectrum of immune-related adverse events, including ICI-induced myocarditis; however, the extent of subclinical acute cardiac effects related to ICI treatment is unclear. Purpose: To explore the extent of cardiac injury and inflammation related to ICI therapy that can be detected with use of cardiac MRI. Materials and Methods: In this prospective study from November 2019 to April 2021, oncologic participants, without known underlying structural heart disease or cardiac symptoms, underwent multi-parametric cardiac MRI before planned ICI therapy (baseline)and 3 months after starting ICI therapy (follow-up). The cardiac MRI protocol incorporated assessment of cardiac function, including systolic myocardial strain, myocardial edema, late gadolinium enhancement (LGE), T1 and T2 relaxation times, and extracellular volume fraction. The paired t test, Wilcoxon signed-rank test, and McNemar test were used for intraindividual comparisons. Results: Twenty-two participants (mean age +/- standard deviation, 65 years +/- 14; 13 men) were evaluated, receiving a median offour infusions of ICI therapy (interquartile range, four to six infusions). Compared with baseline MRI, participants displayed increased markers of diffuse myocardial edema at follow-up ( T1 relaxation time, 972 msec +/- 26 vs 1006 msec +/- 36 [P < .001]; T2 relaxation time, 54 msec +/- 3 vs 58 msec +/- 4 [P < .001]; T2 signal intensity ratio, 1.5 +/- 0.3 vs 1.7 +/- 0.3 [P =.03]). Left ventricular average systolic longitudinal strain had decreased at follow-up MRI (-23.4% +/- 4.8 vs -19.6% +/- 5.1, respectively; P =.005).New nonischemic LGE lesions were prevalent in two of 22 participants (9%). Compared with baseline, small pericardial effusions were more evident at follow-up (one of 22 participants [5%] vs 10 of 22 [45%]; P =.004). Conclusion: In participants who received immune checkpoint inhibitor therapy for cancer treatment, follow-up cardiac MRI scans showed signs of systolic dysfunction and increased parameters of myocardial edema and inflammation. (C) RSNA. 2021