Left Ventricular Geometry and Replacement Fibrosis Detected by cMRI Are Associated with Major Adverse Cardiovascular Events in Nonischemic Dilated Cardiomyopathy

Cojan-Minzat, Bianca Olivia; Zlibut, Alexandru; Mureşan, I; Cionca, Carmen; Horvat, Dalma; Kiss, Éva; Revnic, Radu; Florea, Mira; Ciortea, Răzvan; Agoşton-Coldea, Lucia

doi:10.3390/jcm9061997

Cited by 10 publications

(9 citation statements)

References 39 publications

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“…The extent of myocardial brosis is an important determinant of prognosis. In STEMI, transmural MF usually leads to irreversible ventricular remodeling and heart failure, and is also the pathological basis for arrhythmias, and is generally considered to be associated with sudden cardiac death (29)(30)(31)(32). Nguyen et al (33) found that the severity of myocardial brosis was signi cantly correlated with the frequency of ventricular arrhythmias (r = 0.83, P< 0.01).…”

Section: Discussionmentioning

confidence: 99%

ST-Segment Resolution As A Marker For Severe Myocardial Fibrosis in ST-Segment Elevation Myocardial Infarction

Dong

Wen

Chang

et al. 2021

Preprint

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Objective To investigate the relationship between ST-segment resolution (STR) and myocardial scar thickness after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars. Statistical analyses were performed to assess the utility of STR to predict the development of transmural (> 75%) or non-transmural (< 75%) myocardial scars, according to previous study. Results The sensitivity and specificity of STR for predicting transmural scars were 96% and 88%, respectively, at an STR cut-off value of 40.15%. The area under the curve was 0.92. Multivariate logistic proportional hazards regression analysis disclosed that patients with STR < 40.15% had a 112.95-fold higher probability of developing transmural scars compared with patients with STR ≥ 40.15%. STR percentage was negatively correlated with myocardial scar thickness (β=-0.838, P < 0.001) and size (β=-0.714, P < 0.001). Conclusion STR < 40.15% at 24 h after PCI may provide meaningful diagnostic information regarding the extent of myocardial scarification in STEMI patients.

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Section: Discussionmentioning

confidence: 99%

ST-Segment Resolution As A Marker For Severe Myocardial Fibrosis in ST-Segment Elevation Myocardial Infarction

Dong

Wen

Chang

et al. 2021

Preprint

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“…Late-gadolinium enhancement (LGE) is used in evaluating myocardial fibrosis [ 113 , 114 ], and data from studies are contradictory [ 115 ]. LGE is infrequently observed in patients treated with trastuzumab and anthracyclines, and its absence doesn’t exclude myocardial fibrosis [ 116 , 117 ].…”

Section: Diagnosis Methods Of Chemotherapy-induced Cardiotoxicity In Gi Cancersmentioning

confidence: 99%

Cardiotoxicity Associated with Chemotherapy Used in Gastrointestinal Tumours

et al. 2021

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Cardiotoxicity is a well-recognised side effect of cancer-related therapies with a great impact on outcomes and quality of life in the cancer survivor population. The pathogenesis of chemotherapy-induced cardiotoxicity in patients with gastrointestinal cancers involves various molecular mechanisms, and the combined use of various chemotherapies augments the risk of each drug used alone. In terms of cardiotoxicity diagnosis, novel biomarkers, such as troponins, brain natriuretic peptide (BNP), myeloperoxidases and miRNAs have been recently assessed. Echocardiography is a noninvasive imaging method of choice for the primary assessment of chemotherapy-treated patients to generally evaluate the cardiovascular impact of these drugs. Novel echocardiography techniques, like three-dimensional and stress echocardiography, will improve diagnosis efficacy. Cardiac magnetic resonance (CMR) can evaluate cardiac morphology, function and wall structure. Corroborated data have shown the importance of CMR in the early evaluation of patients with gastrointestinal cancers, treated with anticancer drugs, but further studies are required to improve risk stratification in these patients. In this article, we review some important aspects concerning the cardiotoxicity of antineoplastic drugs used in gastrointestinal cancers. We also discuss the mechanism of cardiotoxicity, the role of biomarkers and the imaging methods used in its detection.

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“…Cardiac fibrosis is one of the hallmarks of DCM and is typically observed in 40–60% of cases [ 5 , 6 ]. Fibrosis significantly contributes to the progression of HF symptoms and functional impairment; it also increases the risk of re-entrant arrhythmias, leading to increased morbidity and mortality in DCM [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Lack of Relationship between Fibrosis-Related Biomarkers and Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis in Dilated Cardiomyopathy

Rubiś

Dziewięcka

Szymańska

et al. 2021

Cells

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The relationship between circulating fibrosis-related molecules and magnetic resonance-assessed cardiac fibrosis in dilated cardiomyopathy (DCM) is poorly understood. To compare circulating biomarkers between DCM patients with high and low fibrosis burdens, we performed a prospective, single-center, observational study. The study population was composed of 100 DCM patients (87 male, mean age 45.2 ± 11.8 years, mean ejection fraction 29.7% ± 10.1%). Replacement fibrosis was quantified by means of late gadolinium enhancement (LGE), whereas interstitial fibrosis was assessed via extracellular volume (ECV). Plasma concentrations of cardiotrophin-1, growth differentiation factor-15, platelet-derived growth factor, procollagen I C-terminal propeptide, procollagen III N-terminal propeptide, and C-terminal telopeptide of type I collagen were measured. There were 44% patients with LGE and the median ECV was 27.7%. None of analyzed fibrosis serum biomarkers were associated with the LGE or ECV, whereas NT-proBNP was independently associated with both LGE and ECV, and troponin T was associated with ECV. None of the circulating fibrosis markers differentiated between DCM patients with and without replacement fibrosis, or patients stratified according to median ECV. However, cardiac-specific markers, such as NT-proBNP and hs-TnT, were associated with fibrosis. Levels of circulating markers of fibrosis seem to have no utility in the diagnosis and monitoring of cardiac fibrosis in DCM.

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Left Ventricular Geometry and Replacement Fibrosis Detected by cMRI Are Associated with Major Adverse Cardiovascular Events in Nonischemic Dilated Cardiomyopathy

Cited by 10 publications

References 39 publications

ST-Segment Resolution As A Marker For Severe Myocardial Fibrosis in ST-Segment Elevation Myocardial Infarction

ST-Segment Resolution As A Marker For Severe Myocardial Fibrosis in ST-Segment Elevation Myocardial Infarction

Cardiotoxicity Associated with Chemotherapy Used in Gastrointestinal Tumours

Lack of Relationship between Fibrosis-Related Biomarkers and Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis in Dilated Cardiomyopathy

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