1
|
Voß F, Nienhaus F, Pietrucha S, Ruckhäberle E, Fehm T, Melz T, Cramer M, Haberkorn SM, Flögel U, Westenfeld R, Scheiber D, Jung C, Kelm M, Polzin A, Bönner F. Anthracycline therapy induces an early decline of cardiac contractility in low-risk patients with breast cancer. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2024; 10:43. [PMID: 39014463 PMCID: PMC11251313 DOI: 10.1186/s40959-024-00244-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024]
Abstract
AIMS Cancer therapy-related cardiac dysfunction (CTRCD) is a dreaded complication of anthracycline therapy. CTRCD most frequently appears in patients with cardiovascular risk factors (CVR) or known cardiovascular disease. However, limited data exist on incidence and course of anthracycline-induced CTRCD in patients without preexisting risk factors. We therefore aimed to longitudinally investigate a cohort of young women on anthracycline treatment due to breast cancer without cardiovascular risk factors or known cardiovascular disease (NCT03940625). METHODS AND RESULTS We enrolled 59 women with primary breast cancer and scheduled anthracycline-based therapy, but without CVR or preexisting cardiovascular disease. We conducted a longitudinal assessment before, immediately and 12 months after cancer therapy with general laboratory, electrocardiograms, echocardiography and cardiovascular magnetic resonance (CMR), including myocardial relaxometry with T1, T2 and extracellular volume mapping. Every single patient experienced a drop in CMR-measured left ventricular ejection fraction (LVEF) of 6 ± 3% immediately after cancer therapy. According to the novel definition 32 patients (54.2%) developed CTRCD after 12 months defined by reduction in LVEF, global longitudinal strain (GLS) and/or biomarkers elevation, two of them were symptomatic. Global myocardial T2 relaxation times as well as myocardial mass increased coincidently with a decline in wall-thickening. While T2 values and myocardial mass normalized after 12 months, LVEF and GLS remained impaired. CONCLUSION In every single patient anthracyclines induce a decline of myocardial contractility, even among patients without pre-existing risk factors for CTRCD. Our data suggest to thoroughly evaluate whether this may lead to an increased risk of future cardiovascular events.
Collapse
Affiliation(s)
- Fabian Voß
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Fabian Nienhaus
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Saskia Pietrucha
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Eugen Ruckhäberle
- Division of Gynecology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Tanja Fehm
- Division of Gynecology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Tobias Melz
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Mareike Cramer
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Sebastian M Haberkorn
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Ulrich Flögel
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
- Department of Molecular Cardiology and Cardiovascular Research Institute Düsseldorf, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Ralf Westenfeld
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Daniel Scheiber
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christian Jung
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
- Medical Faculty, CARID, Cardiovascular Research Institute Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Amin Polzin
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Florian Bönner
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| |
Collapse
|
2
|
Sanadgol G, Samimi S, Shirini D, Nakhaei P, Mohseni M, Alizadehasl A. Right ventricle toxicity in cancer treatment: a focused review on cardiac imaging. Future Cardiol 2023; 19:537-545. [PMID: 37830360 DOI: 10.2217/fca-2022-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Background: The right ventricle (RV) remains the 'forgotten chamber' in the clinical assessment of cancer therapy-related cardiac dysfunction (CTRCD). Aim: We aimed to review the role that various cardiac imaging modalities play in RV assessment as part of the integrative management of patients undergoing cancer therapy. Discussion: RV assessment remains challenging by traditional 2D echocardiography. In this review we discuss other parameters such as right atrial strain, and other echocardiographic modalities such as 3D and stress echocardiography. We also elaborate on the specific role that cardiac magnetic resonance imaging and equilibrium radionuclide angiocardiography can play in assessing the RV. Conclusion: Biventricular function should be monitored following chemotherapy for early detection of subclinical CTRCD and possible solitary RV changes.
Collapse
Affiliation(s)
- Ghazal Sanadgol
- Shahid-Beheshti University of Medical Sciences, Tehran, 1983969411, Iran
| | - Sahar Samimi
- Tehran University of Medical Sciences, Tehran, 1416634793, Iran
| | - Dorsa Shirini
- Cardiovascular Research Center, Shahid Beheshti University of Medical, Tehran, 1983969411, Iran Sciences
| | - Pooria Nakhaei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Mina Mohseni
- Department of Cardio-oncology Research, Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Azin Alizadehasl
- Professor of Cardiology, Echocardiologist, Cardio-oncologist, Cardio-oncology Research Center, Shaheed Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran, 1995614331, Iran
| |
Collapse
|
3
|
Rezaeian N, Hosseini L, Samiei N, Azimian M, Rashidinejad A, Toloueitabar Y, Mehdi Hemmati Komasi M, Shayan L, Asadian S. Aortic Valve Area and Strain Measurements by Cardiac MRI and Transthoracic Echocardiography in Severe Aortic Stenosis with Normal Left Ventricular Function. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:370-378. [PMID: 37456208 PMCID: PMC10349161 DOI: 10.30476/ijms.2022.94552.2590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/17/2022] [Accepted: 07/10/2022] [Indexed: 07/18/2023]
Abstract
Background Transthoracic echocardiography (TTE) is the recommended imaging technique for the evaluation of patients with aortic stenosis (AS). However, in cases with inconclusive findings, cardiac magnetic resonance (CMR) planimetry is used to grade AS severity. This study aimed to compare the results derived from TTE and CMR in patients with severe AS with normal left ventricular (LV) function. Methods In a prospective study, 20 patients with severe AS were recruited and data derived from TTE and CMR modalities were compared with the archived records of 28 age- and sex-matched healthy controls. The data included aortic valve area (AVA), MRI-derived biventricular global strains, and TTE-derived global longitudinal strain (GLS). SPSS software was used to analyze the data with independent samples t test, intraclass correlation coefficient (ICC), and Pearson correlation. P<0.05 was considered statistically significant. Results An excellent agreement was found in AVA values derived from CMR and TTE with an average ICC of 0.932 (95% CI=0.829-0.973). There was a significant difference in LV-GLS, LV global radial strain (GRS), right ventricular (RV) GRS, and RV global circumferential strain between the groups. A good correlation was found between CMR- and TTE-derived GLS with an average ICC of 0.721 (95% C=0.255-0.896). The mean aortic valve pressure gradient in TTE had a significant inverse linear correlation with LV-GRS in CMR (r=-0.537). All P values were <0.05. Conclusion There was a good agreement between AVA and strain values derived from cardiac MRI and TTE. The myocardial strain was impaired in patients with severe AS and normal LV function and correlated with disease severity.
Collapse
Affiliation(s)
- Nahid Rezaeian
- Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Hosseini
- Department of Echocardiography, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Samiei
- Heart Valves Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Azimian
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- Department of Interventional Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yaser Toloueitabar
- Department of Cardiac Surgery, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Leila Shayan
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Asadian
- Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Abdi S, Taheri N, Zahedi Haghighi F, Khaki M, Najafi H, Hemmati Komasi MM, Hassani B. The relationship of myocardial and liver T2* values with cardiac function and laboratory findings in transfusion-dependent thalassemia major patients: A retrospective cardiac MRI study. J Cardiovasc Thorac Res 2023; 15:86-92. [PMID: 37654812 PMCID: PMC10466462 DOI: 10.34172/jcvtr.2023.31592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 05/23/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Cardiac complications are the leading cause of death in thalassemia patients. It is assumed that progressive iron accumulation results in myocyte damage. Myocardial T2* measurement by cardiac MRI quantifies iron overload. We aimed to study the association between left and right ventricular (LV and RV) function and iron deposition estimation by cardiac MRI T2* in a sample of Iranian patients. Methods Cardiac MRI exams of 118 transfusion-dependent thalassemia major patients were evaluated retrospectively. Biventricular function and volume and myocardial and liver T2* values were measured. The demographic and lab data were registered. Poisson and chi-square regression analyses investigated the correlation between the T2* value and ventricular dysfunction. Results The study participants' mean (SD) age was 32.7y (9.02), and 47.46% were female. Forty-nine cases (41.52%) revealed at least uni-ventricular dysfunction. LV dysfunction was noted in 20 cases, whereas 47 patients revealed RV dysfunction. The risk of LV dysfunction was 5.3-fold higher in patients with cardiac T2* value less than 10msec (RR=5.3, 95% CI=1.6, 17.1, P<0.05). No association was found between age, liver T2* value, serum ferritin level, and chelation therapy with the risk of LV and RV dysfunction. Conclusion Cardiac MRI T2* measure is a good indicator of LV dysfunction. Moreover, MRI parameters, especially RV functional measures, may have a substantial role in patient management. Therefore, cardiac MRI should be included in beta-thalassemia patients' management strategies.
Collapse
Affiliation(s)
- Sepideh Abdi
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Taheri
- Cancer Research Institute, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zahedi Haghighi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahya Khaki
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Homa Najafi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Behrooz Hassani
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Tian Y, Wang T, Tian L, Yang Y, Xue C, Sheng W, Wang C. Early detection and serial monitoring during chemotherapy-radiation therapy: Using T1 and T2 mapping cardiac magnetic resonance imaging. Front Cardiovasc Med 2023; 10:1085737. [PMID: 37063950 PMCID: PMC10090395 DOI: 10.3389/fcvm.2023.1085737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
PurposeTo confirm the ability of native T1 and T2 values in detecting and monitoring early myocardial injuries of chest radiotherapy in neoplasm patients.Materials and methodsFifteen participants received non-anthracycline chemotherapy and chest radiotherapy, and 30 age/gender-matched controls were enrolled in this prospective study. Cardiac magnetic resonance scans were performed within 2 days, 3 months, and 6 months after chest radiotherapy. Myocardial native T1 and T2 values were measured in irradiated and nonirradiated areas. Meanwhile, the parameters of left ventricular function and left ventricular myocardial strain were obtained.ResultsThere were no significant differences in left ventricular function, native T1, T2, and strain between patients and controls before chest radiotherapy. In 15 participants who were followed up for 6 months, there was a significant change only in left ventricular ejection fraction (LVEF) among baseline and the first follow-up (P = 0.021), while the adjusted P-value was higher than 0.05 after Bonferroni correction, as well as other parameters. Native T1 values were elevated at 3 and 6 months in irradiated areas compared with baseline (1,288.72 ± 66.59 ms vs. 1,212.51 ± 45.41 ms; 1,348.01 ± 54.16 ms vs. 1,212.51 ± 45.41 ms; P < 0.001 for both). However, T2 values only changed at 3 months in irradiated areas compared with baseline (44.21 ± 3.35 ms vs. 39.14 ± 1.44 ms; P = 0.006). Neither the native T1 nor T2 values changed in nonirradiated areas during the follow-up period (all P > 0.05). There were no significant differences in strain changes during the follow-up period (all P > 0.05).ConclusionNative T1 and T2 values elevated at 3 months after chest radiotherapy, whereas LVEF showed no significant change during the 6-month follow-up.
Collapse
Affiliation(s)
- Yaotian Tian
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Teng Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Liwen Tian
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yucheng Yang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chen Xue
- Department of Radiology, Shandong Provincial Hospital, Binzhou Medical University, Jinan, China
| | - Wei Sheng
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Cuiyan Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Correspondence: Cuiyan Wang
| |
Collapse
|
6
|
Motevalli M, Asadian S, Khademi F, Rezaeian N, Shayan L. The crucial role of cardiac MRI parameters in the prediction of outcomes in acute clinically suspected myocarditis: A functional and feature-tracking study. Front Cardiovasc Med 2022; 9:946435. [PMID: 36158830 PMCID: PMC9490401 DOI: 10.3389/fcvm.2022.946435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background The definitive diagnosis of myocarditis is made by endomyocardial biopsy, but it is an invasive method. Recent investigations have proposed that cardiac MRI parameters have both diagnostic and prognostic roles in assessing myocarditis. We aimed to evaluate the role of functional and feature-tracking (FT)-derived strain values in predicting major adverse cardiovascular events (MACE) in patients with acute myocarditis. Methods and results We evaluated 133 patients with acute myocarditis (74.4% men) between January 2016 and February 2021. During a mean follow-up of 31 ± 16 months, sixteen patients (12.03%) experienced MACE: three deaths (2.3%), nine ICD implantations (6.76%), and five cardiac transplantations (3.8%). The left ventricular ejection fraction (LVEF), the LV end-diastolic volume index (EDVI), and the LV global longitudinal strain (GLS) were the strongest predictors of MACE. Each 1-unit decline in LVEF and LVGLS or 1-unit rise in LVEDVI resulted in a 5, 24, and 2% increase in MACE, respectively. LVEF ≤36.46% and LVGLS ≤9% indicated MACE with 75% sensitivity and 74.4 and 73.5% specificity, respectively. Conclusions In a group of acute myocarditis patients with evidence of myocardial edema and late Gadolinium enhancement, LVEF and GLS were the strongest predictors of adverse cardiac events.
Collapse
Affiliation(s)
- Marzieh Motevalli
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sanaz Asadian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Foroogh Khademi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Rezaeian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- *Correspondence: Nahid Rezaeian
| | - Leila Shayan
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Gambril JA, Chum A, Goyal A, Ruz P, Mikrut K, Simonetti O, Dholiya H, Patel B, Addison D. Cardiovascular Imaging in Cardio-Oncology: The Role of Echocardiography and Cardiac MRI in Modern Cardio-Oncology. Heart Fail Clin 2022; 18:455-478. [PMID: 35718419 PMCID: PMC9280694 DOI: 10.1016/j.hfc.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cardiovascular (CV) events are an increasingly common limitation of effective anticancer therapy. Over the last decade imaging has become essential to patients receiving contemporary cancer therapy. Herein we discuss the current state of CV imaging in cardio-oncology. We also provide a practical apparatus for the use of imaging in everyday cardiovascular care of oncology patients to improve outcomes for those at risk for cardiotoxicity, or with established cardiovascular disease. Finally, we consider future directions in the field given the wave of new anticancer therapies.
Collapse
Affiliation(s)
- John Alan Gambril
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA; Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA. https://twitter.com/GambrilAlan
| | - Aaron Chum
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA; Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA
| | - Akash Goyal
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA; Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA. https://twitter.com/agoyalMD
| | - Patrick Ruz
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA; Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA
| | - Katarzyna Mikrut
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA. https://twitter.com/KatieMikrut
| | - Orlando Simonetti
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA; Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA; Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH, USA; Department of Radiology, The Ohio State University Medical Center, Columbus, OH, USA
| | - Hardeep Dholiya
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA; Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA. https://twitter.com/Hardeep_10
| | - Brijesh Patel
- Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA; Cardio-Oncology Program, Heart and Vascular Institute, West Virginia University, Morgantown, WV, USA
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA; Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
8
|
Asadian S, Farzin M, Tabesh F, Rezaeian N, Bakhshandeh H, Hosseini L, Toloueitabar Y, Hemmati Komasi MM. The Auxiliary Role of Cardiac Magnetic Resonance Feature-Tracking Parameters in the Differentiation between Cardiac Amyloidosis and Constrictive Pericarditis. Cardiol Res Pract 2021; 2021:2045493. [PMID: 34725571 PMCID: PMC8557086 DOI: 10.1155/2021/2045493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/30/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Cardiac amyloidosis (CA) and constrictive pericarditis (CP) are described as the differential diagnoses of restrictive hemodynamic alterations of the heart. We aimed to explain cardiac magnetic resonance (CMR) imaging findings (especially feature tracking (FT)) of CA and CP cases and compare them with healthy controls. Moreover, we evaluated the role of biventricular FT parameters in differentiating CA from CP. METHODS Thirty-eight patients who underwent CMR between February 2016 and January 2018 with the ultimate diagnosis of CA (19 patients) or CP (19 patients) were enrolled. We included biopsy-proven light-chain amyloidosis patients. The data of 28 healthy controls were utilized for comparison. The patients were followed up for 8-23 months to register mortality and their surveillance. All CMR morphological and functional data, including FT parameters, were recorded and analyzed. RESULTS Of only 13/19 (68.4%) CA patients who had the follow-up data, 11/13 (84.6%) died. One of The CP patients (5.3%) expired during the follow-up. Significant between-group differences were noted concerning the biventricular ejection fraction as well as global longitudinal, circumferential, and radial strain values (Ps < 0.001). The left ventricular (LV) global longitudinal strain (GLS) ≤10% was detected in 13/19 (68.4%) of the CA and 1/19 (5.3%) of CP cases (P < 0.001). A significant difference between the mean value of the LVGLS and LV global circumferential strain (GCS) of the basal LV level compared to the mid and apical levels was observed (Ps < 0.001) in the CA patients. The differences between the mean LVGLS and the GCS measures of the mid and apical LV levels were not significant (P=1 and P=0.06, respectively). CONCLUSIONS In our study, CA and CP severely disrupted ventricular strains. Biventricular GLS was meaningfully lower in the CA subjects. Therefore, strain analysis, especially in the longitudinal direction, could be helpful to differentiate CA from CP.
Collapse
Affiliation(s)
- Sanaz Asadian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahta Farzin
- Iran University of Medical Sciences, Tehran, Iran
| | - Faezeh Tabesh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Rezaeian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Bakhshandeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Hosseini
- North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Yaser Toloueitabar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|