Cardiac Magnetic Resonance T1 Mapping in Adolescent and Young Adult Survivors of Childhood Cancers

Tong, Xin; Li, Vivian Wing‐yi; Liu, Anthony Pak-Yin; So, Edwina Kam-fung; Chan, Queenie; Ho, Karin Kar-Huen; Yau, Jeffrey P W; Cheuk, Dkl; Cheung, Yiu‐fai; Ng, Ming-Yen

doi:10.1161/circimaging.118.008453

Cited by 14 publications

(8 citation statements)

References 5 publications

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“…With development of improved T1 mapping sequences [21] , [22] , the use of T1 for noninvasive quantification of myocardial iron load in thalassaemia is increasing [3] , [4] , [23] , [24] . Our findings of decreased native T1 values, as compared to published reference values [14] , [15] , [16] , [17] , and correlations between T1 and T2* values in patients with beta-thalassaemia major agree with those reported previously [3] , [8] . Interestingly, Sado et al found that about one-third of patients with various underlying causes referred for assessment of myocardial iron load had reduced myocardial T1 despite having normal T2* [4] .…”

Section: Discussionsupporting

confidence: 92%

“…Table 2 summarizes the previously reported native T1 values obtained using similar magnetic field strength and mapping sequence. The T1 value in our patients was 947.1 ± 84.8 ms, which was significantly lower compared with the published normative values based on 1.5 T CMR systems [14] , [15] , [16] and our previously reported normative values based on 3 T MRI system [17] .…”

Section: Resultscontrasting

confidence: 87%

“…Local references based on 1.5 T MRI system are not available to date and we have therefore used reference values derived using similar magnetic strength and mapping sequence. [14] , [15] , [16] Additionally, we have compared the native T1 values of patients against our previously published local reference values based on 3 T MRI system [17] , which has been shown to generate similar T1 values as that of the 1.5 T MRI system [35] . Second, this is a relatively small scale cross-sectional study that does not provide data on the longitudinal changes of T1 with alteration of atrial and ventricular mechanics.…”

Section: Discussionmentioning

confidence: 99%

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Native cardiac magnetic resonance T1 mapping and cardiac mechanics as assessed by speckle tracking echocardiography in patients with beta-thalassaemia major

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Hwang

et al. 2022

IJC Heart & Vasculature

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Background We hypothesize that cardiac magnetic resonance (CMR) native T1 is associated with myocardial deformation in thalassaemia patients. The present study aimed to compare CMR native T1 values to conventional T2* values in patients with beta-thalassaemia and to explore relationships between these CMR parameters of myocardial iron overload and left ventricular (LV) and left atrial (LA) myocardial deformation. Methods Thirty-four (16 males) patients aged 35.5 ± 9.2 years were studied. Myocardial T2* and T1 mapping were performed to assess the cardiac iron overload, while two-dimensional speckle-tracking echocardiography was performed in determine LV and LA myocardial deformation. Results T2* was 36.4 ± 8.7 ms with 3 patients having myocardial iron load (T2*<20 ms). The native T1 was 947.1 ± 84.8 ms, which was significantly lower than the reported normal values in the literature. There was a significant correlation between T1 and T2* values (r = 0.68, p < 0.001). There were no significant correlations between T1 and T2* values and conventional and tissue Doppler parameters of left ventricular systolic and diastolic function. On the other hand, T1, but not T2*, values were found to correlate negatively with maximum LA area indexed by body surface area (r = -0.34, p = 0.047) and positively with LA strain rate at atrial contraction (r = 0.36, p = 0.04). There were no associations between either of these CMR parameters with indices of ventricular deformation. Conclusions In patients with beta-thalassaemia major, native T1 values are decreased, associated with T2* values, and correlated with maximum LA area and LA strain rate at atrial contraction.

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Section: Discussionsupporting

confidence: 92%

Section: Resultscontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Native cardiac magnetic resonance T1 mapping and cardiac mechanics as assessed by speckle tracking echocardiography in patients with beta-thalassaemia major

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Hwang

et al. 2022

IJC Heart & Vasculature

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“…Some studies report anthracycline-treated childhood cancer survivors to show modest myocardial fibrosis as evident by an increased extracellular volume fraction (35). On the other hand, other studies demonstrate the absence of a statistically significant increase in myocardial fibrosis in survivors compared to healthy control subjects (43,44). Since there is no clinical data reporting the association between myocardial fibrosis and cardiovascular risk factors in anthracycline-treated survivors, it may be possible that the discrepancy in these clinical studies arise from the confounding effect of other cardiovascular diseases, particularly hypertension.…”

Section: Discussionmentioning

confidence: 99%

Divergent Cardiac Effects of Angiotensin II and Isoproterenol Following Juvenile Exposure to Doxorubicin

Agostinucci

Grant

Seelig

et al. 2022

Front. Cardiovasc. Med.

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Hypertension is the most significant risk factor for heart failure in doxorubicin (DOX)-treated childhood cancer survivors. We previously developed a two-hit mouse model of juvenile DOX-induced latent cardiotoxicity that is exacerbated by adult-onset angiotensin II (ANGII)-induced hypertension. It is still not known how juvenile DOX-induced latent cardiotoxicity would predispose the heart to pathologic stimuli that do not cause hypertension. Our main objective is to determine the cardiac effects of ANGII (a hypertensive pathologic stimulus) and isoproterenol (ISO, a non-hypertensive pathologic stimulus) in adult mice pre-exposed to DOX as juveniles. Five-week-old male C57BL/6N mice were administered DOX (4 mg/kg/week) or saline for 3 weeks and then allowed to recover for 5 weeks. Thereafter, mice were administered either ANGII (1.4 mg/kg/day) or ISO (10 mg/kg/day) for 14 days. Juvenile exposure to DOX abrogated the hypertrophic response to both ANGII and ISO, while it failed to correct ANGII- and ISO-induced upregulation in the hypertrophic markers, ANP and BNP. ANGII, but not ISO, worsened cardiac function and exacerbated cardiac fibrosis in DOX-exposed mice as measured by echocardiography and histopathology, respectively. The adverse cardiac remodeling in the DOX/ANGII group was associated with a marked upregulation in several inflammatory and fibrotic markers and altered expression of Ace, a critical enzyme in the RAAS. In conclusion, juvenile exposure to DOX causes latent cardiotoxicity that predisposes the heart to a hypertensive pathologic stimulus (ANGII) more than a non-hypertensive stimulus (ISO), mirroring the clinical scenario of worse cardiovascular outcome in hypertensive childhood cancer survivors.

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“…Several studies have previously established that native T1 is elevated in CKD patients ranging from early CKD to end-stage renal failure [3,4,8]. However, there are many variables which can affect the native T1 values such as scanner type, tesla strength, gender and type of T1 mapping sequence [6,9].…”

mentioning

confidence: 99%

Chronic kidney disease with elevated myocardial native T1 – Is this only due to myocardial fibrosis?

Yap

Yiu

2019

IJC Heart & Vasculature

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Cardiac Magnetic Resonance T1 Mapping in Adolescent and Young Adult Survivors of Childhood Cancers

Cited by 14 publications

References 5 publications

Native cardiac magnetic resonance T1 mapping and cardiac mechanics as assessed by speckle tracking echocardiography in patients with beta-thalassaemia major

Native cardiac magnetic resonance T1 mapping and cardiac mechanics as assessed by speckle tracking echocardiography in patients with beta-thalassaemia major

Divergent Cardiac Effects of Angiotensin II and Isoproterenol Following Juvenile Exposure to Doxorubicin

Chronic kidney disease with elevated myocardial native T1 – Is this only due to myocardial fibrosis?

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