Prognostic Value of T1 Mapping and Feature Tracking by Cardiac Magnetic Resonance in Patients With Signs and Symptoms Suspecting Heart Failure and No Clinical Evidence of Coronary Artery Disease

Seno, Ayako; Antiochos, Panagiotis; Lichtenfeld, Helena; Rickers, E.; Qamar, Iqra; Ge, Yin; Blankstein, Ron; Steigner, Michael L.; Aghayev, Ayaz; Jerosch‐Herold, Michael; Kwong, Raymond Y.

doi:10.1161/jaha.121.020981

Cited by 8 publications

(2 citation statements)

References 37 publications

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“…Thus, it shows diffuse abnormal changes in the cardiac tissue that may precede myocardial dysfunction [ 24 ]. Nevertheless, it should be noted that the use of both measures together, GLS and native T1 mapping, may provide a stronger prognostic association with cardiac changes [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis

Mohamed,

Elmancy,

Abulola

et al. 2024

Cardiovasc Toxicol

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Anthracycline antibiotic is one of the most effective anti-tumor drugs used to manage certain types of breast cancers, lymphomas, and leukemias. However, anthracyclines induce a dose-dependent cardiotoxicity that may progress to heart failure. Thus, using a sensitive predictor of early cardiac dysfunction in patients treated with anthracyclines can help detect subclinical cardiac dysfunction early and help initiate interventions to protect these patients. Among parameters of myocardial measure, cardiac magnetic resonance (CMR)-measured native myocardial T1 mapping is considered a sensitive and accurate quantitative measure of early subclinical cardiac changes, particularly cardiac inflammation and fibrosis. However, to understand the quality and the validity of the current evidence supporting the use of these measures in patients treated with anthracyclines, we aimed to conduct a systematic review of clinical studies of this measure to detect early myocardial changes in cancer patients treated with anthracyclines. The primary outcome was the level of native T1 mapping. We performed fixed-effects meta-analyses and assessed certainty in effect estimates. Of the 1780 publications reviewed (till 2022), 23 were retrieved, and 9 articles met the inclusion criteria. Our study showed that exposure to anthracycline was associated with a significant elevation of native myocardial T1 mapping from baseline (95% CI 0.1121 to 0.5802; p = 0.0037) as well as compared to healthy control patients (95% CI 0.2925 to 0.7448; p < 0.0001). No significant publication bias was noted on the assessment of the funnel plot and Egger’s test. According to the Q test, there was no significant heterogeneity in the included studies (I2 = 0.0000% versus healthy controls and I2 = 14.0666% versus baseline). Overall, our study suggests that native myocardial T1 mapping is useful for detecting anthracycline-induced cardiotoxicity in patients with cancer.

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Section: Discussionmentioning

confidence: 99%

Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis

Mohamed,

Elmancy,

Abulola

et al. 2024

Cardiovasc Toxicol

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“…The incidence rate is increasing year by year, and the mortality and disability rates are high. Some studies have shown that patients with coronary artery stenosis, myocardial ischemia and hypoxia, lead to impaired glucose uptake capacity of cells, a large amount of lactic acid accumulation of cells, and then damage myocardial cells, causing cardiovascular events, with a high mortality [21,22] .…”

Section: Table 3: Analysis Of Treatment Effectiveness Of Patients In ...mentioning

confidence: 99%

Effect of Atorvastatin Calcium Combined with Sakubatravalsartan in Coronary Heart Disease Complicated with Cardiac Insufficiency

Zhou,

Liu

2023

IJPS

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Zhou et al.: Efficacy and Safety of Atorvastatin Combined with Sacubitril-valsartan in Coronary Heart Disease To explore the efficacy and safety of atorvastatin combined with sacubitril-valsartan in patients with coronary heart disease complicated with cardiac insufficiency. A total of 188 patients with coronary heart disease combined with cardiac dysfunction were included in this study, of which 73 patients received atorvastatin and 115 patients received atorvastatin combined with sacubitril-valsartan. According to the efficacy criteria, the efficacy of atorvastatin group and atorvastatin+sacubitril-valsartan group was determined. The changes of left ventricular mass index, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular end-diastolic volume and N-terminal pro-brain natriuretic peptide before and after treatment were detected in the two groups. The inflammatory response of patients was evaluated by comparing the changes of interleukin-6 and high-sensitivity C-reactive protein before and after treatment. Adverse reactions occurred during treatment were collected to determine the safety of treatment. Before treatment, there was clearly no significant difference between the two groups. After treatment, most of the patients in the atorvastatin and atorvastatin+sacubitril-valsartan groups showed significant efficacy, while the efficacy in the atorvastatin+sacubitril-valsartan group was better than that in the atorvastatin group. After 6 mo of treatment, left ventricular mass index, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular end-diastolic volume and N-terminal pro-brain natriuretic peptide in atorvastatin+sacubitril-valsartan group were superior to those in atorvastatin group. At the same time, the levels of inflammatory cytokines in the atorvastatin+sacubitrilvalsartan group were obviously lower than those in the atorvastatin group after 6 mo of treatment. The adverse events that occurred during treatment in the atorvastatin and atorvastatin+sacubitril-valsartan groups mainly included hypotension, hyperkalemia, fecal occult blood, hematuria and arrhythmia.There was no significant difference in the incidence of adverse reactions in the atorvastatin+sacubitrilvalsartan group compared with the atorvastatin group. The efficacy of atorvastatin plus sacubitrilvalsartan group was higher than that of atorvastatin group. Atorvastatin combined with sacubitrilvalsartan has a significant effect on patients with coronary heart disease and cardiac insufficiency.

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Risk Stratification in Nonischemic Dilated Cardiomyopathy Using CMR Imaging

Eichhorn,

Koeckerling,

Reddy

et al. 2024

JAMA

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ImportanceAccurate risk stratification of nonischemic dilated cardiomyopathy (NIDCM) remains challenging.ObjectiveTo evaluate the association of cardiac magnetic resonance (CMR) imaging–derived measurements with clinical outcomes in NIDCM.Data SourcesMEDLINE, Embase, Cochrane Library, and Web of Science Core Collection databases were systematically searched for articles from January 2005 to April 2023.Study SelectionProspective and retrospective nonrandomized diagnostic studies reporting on the association between CMR imaging–derived measurements and adverse clinical outcomes in NIDCM were deemed eligible.Data Extraction and SynthesisPrespecified items related to patient population, CMR imaging measurements, and clinical outcomes were extracted at the study level by 2 independent reviewers. Random-effects models were fitted using restricted maximum likelihood estimation and the method of Hartung, Knapp, Sidik, and Jonkman.Main Outcomes and MeasuresAll-cause mortality, cardiovascular mortality, arrhythmic events, heart failure events, and major adverse cardiac events (MACE).ResultsA total of 103 studies including 29 687 patients with NIDCM were analyzed. Late gadolinium enhancement (LGE) presence and extent (per 1%) were associated with higher all-cause mortality (hazard ratio [HR], 1.81 [95% CI, 1.60-2.04]; P &lt; .001 and HR, 1.07 [95% CI, 1.02-1.12]; P = .02, respectively), cardiovascular mortality (HR, 2.43 [95% CI, 2.13-2.78]; P &lt; .001 and HR, 1.15 [95% CI, 1.07-1.24]; P = .01), arrhythmic events (HR, 2.69 [95% CI, 2.20-3.30]; P &lt; .001 and HR, 1.07 [95% CI, 1.03-1.12]; P = .004) and heart failure events (HR, 1.98 [95% CI, 1.73-2.27]; P &lt; .001 and HR, 1.06 [95% CI, 1.01-1.10]; P = .02). Left ventricular ejection fraction (LVEF) (per 1%) was not associated with all-cause mortality (HR, 0.99 [95% CI, 0.97-1.02]; P = .47), cardiovascular mortality (HR, 0.97 [95% CI, 0.94-1.00]; P = .05), or arrhythmic outcomes (HR, 0.99 [95% CI, 0.97-1.01]; P = .34). Lower risks for heart failure events (HR, 0.97 [95% CI, 0.95-0.98]; P = .002) and MACE (HR, 0.98 [95% CI, 0.96-0.99]; P &lt; .001) were observed with higher LVEF. Higher native T1 relaxation times (per 10 ms) were associated with arrhythmic events (HR, 1.07 [95% CI, 1.01-1.14]; P = .04) and MACE (HR, 1.06 [95% CI, 1.01-1.11]; P = .03). Global longitudinal strain (GLS) (per 1%) was not associated with heart failure events (HR, 1.06 [95% CI, 0.95-1.18]; P = .15) or MACE (HR, 1.03 [95% CI, 0.94-1.14]; P = .43). Limited data precluded definitive analysis for native T1 relaxation times, GLS, and extracellular volume fraction (ECV) with respect to mortality outcomes.ConclusionThe presence and extent of LGE were associated with various adverse clinical outcomes, whereas LVEF was not significantly associated with mortality and arrhythmic end points in NIDCM. Risk stratification using native T1 relaxation times, extracellular volume fraction, and global longitudinal strain requires further evaluation.

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Prognostic Value of T1 Mapping and Feature Tracking by Cardiac Magnetic Resonance in Patients With Signs and Symptoms Suspecting Heart Failure and No Clinical Evidence of Coronary Artery Disease

Cited by 8 publications

References 37 publications

Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis

Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis

Effect of Atorvastatin Calcium Combined with Sakubatravalsartan in Coronary Heart Disease Complicated with Cardiac Insufficiency

Risk Stratification in Nonischemic Dilated Cardiomyopathy Using CMR Imaging

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