Computed Tomographic Angiography Assessment of Epicardial Coronary Vasoreactivity for Early Detection of Doxorubicin-Induced Cardiotoxicity

Dual Angiotensin Receptor-Neprilysin Inhibition With Sacubitril/Valsartan Attenuates Systolic Dysfunction in Experimental Doxorubicin-Induced Cardiotoxicity

“…Therefore, we cannot determine whether protection afforded by Sac/Val would have been more evident with more severe cardiotoxicity, nor can we rule out that the Sac/Val effects on LV remodeling and dysfunction were in part due to alterations in preload or afterload. Therefore, to fully realize the full potential of Sac/Val in the setting of chronic DOX administration, future studies should employ large animal models, in which intravenous injection of DOX and arterial pressures are more easily applied, as recently described by our group ( 33 ). Lastly, healthy rats were used in this study; thus, whether Sac/Val therapy interferes with the antineoplastic effects of DOX is unknown at this juncture.…”

Novel Cardiac Computed Tomography Methods for the Assessment of Anthracycline Induced Cardiotoxicity

“…Left ventricular global longitudinal strain (GLS) as assessed by 2-dimensional transthoracic echocardiography is a well described early predictor of AIC ( 27 , 28 ). LV GLS is a more sensitive, reproducible measure of LV dysfunction when compared to LVEF.…”

“…Recently, our group has developed a novel CT based strategy for the evaluation of coronary microvascular dysfunction associated with AIC ( 28 ). In this study, we used a canine model of doxorubicin-induced cardiotoxicity, where canines received weekly intravenous doxorubicin (1 mg/kg) for 12–15 weeks resulting in significant reduction in the left ventricular ejection fraction and histological evidence of cardiotoxicity by the end of therapy.…”

“…2D = 2-dimensional; TTE = transthoracic echocardiography. Note: this image is reproduced with permission from Feher et al ( 28 ).…”

New Insights in Early Detection of Anticancer Drug-Related Cardiotoxicity Using Perfusion and Metabolic Imaging

“…Impairment of epicardial arteries vasodilatation, by evaluation of change in coronary diameters under pharmacological stress, has been reported after DOX infusions on CT angiography suggesting dysfunction of smooth cells and the microvascular bed (78). However, the resolution of cardiac CT is insufficient to visually assess microvessels, underlining the need for cardiac perfusion CT to assess myocardial microcirculation by detecting hypoperfused territories.…”