Cardiac Magnetic Resonance Imaging for the Assessment of the Myocardium After Doxorubicin-based Chemotherapy. (August 2015)

• Record Type: Journal Article
• Authors: Lunning, Matthew A.; Kutty, Shelby; Rome, Eric T.; Li, Ling; Padiyath, Asif; Loberiza, Fausto; Bociek, Robert Gregory; Bierman, Philip J.; Vose, Julie M.; Armitage, James O.; Porter, Thomas R.
• Is Part Of: American journal of clinical oncology. Volume 38:Number 4(2015)
• Publication Date: 2015-08
• Subjects: anthracycline -- doxorubicin -- cardiomyopathy -- cardiac magnetic resonance imaging -- lymphoma; Cancer -- Treatment -- Periodicals; Oncology -- Periodicals; Tumors -- Periodicals; 616.994005
• DOI: 10.1097/COC.0b013e31829e19be
• Languages: English
• ISSNs: 0277-3732

Abstract

Abstract : Objectives: Doxorubicin is associated with a cumulative dose–dependent nonischemic cardiomyopathy. Cardiac magnetic resonance imaging (cMRI) is able to examine both structural and functional components of the myocardium. Our aim was to assess the myocardial changes in non-Hodgkin lymphoma patients undergoing doxorubicin-based chemotherapy using cMRI. Materials and Methods: cMRI examination was performed before and 3 months after chemotherapy. Experienced investigators interpreted each cMRI, and were blinded to all data. Left ventricular ejection fractions (LVEF), cardiac deformation, and delayed gadolinium enhancement (GD-DE) were quantified for each cMRI. The change between LVEF, GD-GE, and cardiac deformation parameters were compared between the 2 cMRI studies. A Δ LVEF≥10% was considered clinically relevant. The findings of GD-GE or changes in myocardial strain were analyzed as independent variables. Results: All 10 patients enrolled received a cumulative dose of doxorubicin of 300 mg/m 2 . A comparison of pretreatment and posttreatment cMRI demonstrated 5 (50%) patients with a ≥10% decrease in LVEF (median, −8.4%; range, 1% to −17%; P =0.004). Three patients had at least 1 new or progressive segment of GD-DE. The global circumferential strain was significantly lower in patients after treatment, as compared with values before treatment ( P =0.018) and to normal controls ( P =0.046). Patients after treatment also had significantly lower global longitudinal strain than controls ( P =0.035), and longitudinal strain values that tended to decrease compared with pretreatment values ( P =0.073). Discussion: Our data suggests that cMRI has the ability to assess both early structural and functional myocardial changes in association with doxorubicin-based chemotherapy.