When Left Ventricular Extracellular Volume Fraction Changes After Anthracyclines

Hundley, W. Gregory; Jordan, Jennifer H.

doi:10.1016/j.jcmg.2018.06.006

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…ECV refers to the volume of extracellular matrix as a percentage of the total volume of myocardial tissue, which can be calculated using pre- and post-contrast T1 mapping with good reproducibility. ECV is mainly affected by the interstitial space and myocellular volume or mass [ 102 ], and has been proven to correlate well with the histological collagen volume fraction and extracellular space [ 103 , 104 ]. Several studies have demonstrated increased ECV in patients [ 101 , 105 , 106 , 107 ] and animal models [ 40 , 108 , 109 ] treated with anthracycline, which may occur as early as 3 months after chemotherapy [ 107 ].…”

Section: Cmr Imaging Biomarkers In the Assessment Of Cardiotoxicitymentioning

confidence: 99%

Cardiovascular Magnetic Resonance Imaging in the Early Detection of Cardiotoxicity Induced by Cancer Therapies

Wei

Zhang

et al. 2022

Diagnostics

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The significant progress in cancer treatment, including chemotherapy, immunotherapy, radiotherapy, and combination therapies, has led to higher long-term survival rates in cancer patients, while the cardiotoxicity caused by cancer treatment has become increasingly prominent. Cardiovascular magnetic resonance (CMR) is a non-invasive comprehensive imaging modality that provides not only anatomical information, but also tissue characteristics and cardiometabolic and energetic assessment, leading to its increased use in the early identification of cardiotoxicity, and is of major importance in improving the survival rate of cancer patients. This review focused on CMR techniques, including myocardial strain analysis, T1 mapping, T2 mapping, and extracellular volume fraction (ECV) calculation in the detection of early myocardial injury induced by cancer therapies. We summarized the existing studies and ongoing clinical trials using CMR for the assessment of subclinical ventricular dysfunction and myocardial changes at the tissue level. The main focus was to explore the potential of clinical and preclinical CMR techniques for continuous non-invasive monitoring of myocardial toxicity associated with cancer therapy.

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Section: Cmr Imaging Biomarkers In the Assessment Of Cardiotoxicitymentioning

confidence: 99%

Cardiovascular Magnetic Resonance Imaging in the Early Detection of Cardiotoxicity Induced by Cancer Therapies

Wei

Zhang

et al. 2022

Diagnostics

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“…Prolongation of T1 and T2 mapping relaxation times reflect myocardial tissue injury and edema, respectively, and extracellular volume (ECV) -a metric derived from T1 maps acquired before and after gadolinium contrastmeasures the expansion of the interstitial space and denotes interstitial fibrosis and/or edema. Recently, a novel CMR technique has emerged that is capable of measuring the size of cardiomyocytes by water lifetime measurements (τ ic ) [6], which can discriminate whether cardiomyocyte atrophy contributes to the expansion of the ECV [7][8][9]. These imaging biomarkers have provided important insights about complex myocellular and interstitial remodeling processes of anthracycline-mediated cardiotoxicity.…”

Section: Cmr In the Cardiovascular Evaluation Of The Cancer Patientmentioning

confidence: 99%

The Role of Cardiac MRI in Animal Models of Cardiotoxicity: Hopes and Challenges

Park

Morrison

Vasu

et al. 2020

J. of Cardiovasc. Trans. Res.

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Animal models of chemotherapy-induced cardiotoxicity have been instrumental in understanding the underlying mechanisms of the disease. The use of cardiac magnetic resonance imaging (CMR) and nuclear magnetic resonance imaging (NMR) in preclinical models allow the non-invasive study of subclinical pathophysiological processes that influence cardiac function and establish imaging parameters that can be adopted into clinical practice to predict cardiovascular outcomes. Given the rising population of cancer survivors and the current lack of effective therapies for the management of cardiotoxicity, research combining clinically relevant animal models and noninvasive cardiac imaging remains essential to improve methods to monitor, predict, and treat cardiovascular adverse events. This comprehensive review summarizes the lessons learned from animal models of cardiotoxicity employing CMR and tissue characterization techniques and discusses the ongoing challenges and hopes for the future.

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“…Increases in extracellular volume fraction and total extracellular volume have also been observed in small studies of patients receiving anthracycline chemotherapy, potentially suggestive of edema and fibrosis. However, the mechanistic basis for this increase in extracellular volume fraction was recently challenged in a study of patients who received anthracycline chemotherapy, with results suggesting that increases in myocardial extracellular volume fraction may not necessarily be due to expansion of interstitial space but may actually be related to decreases in myocellular volume and mass (32). T2 mapping has similarly demonstrated utility in detecting subclinical cardiotoxicity, as it enables qualitative and quantitative assessment of water content, which may increase after myocellular or microvascular injury.…”

Section: Cmr Imaging Metricsmentioning

confidence: 99%

Precision Cardio-Oncology

et al. 2019

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Modern oncologic therapies and care have resulted in a growing population of cancer survivors with comorbid, chronic health conditions. As an example, many survivors have an increased risk of cardiovascular complications secondary to cardiotoxic systemic and radiation therapies. In response, the field of cardio-oncology has emerged as an integral component of oncologic patient care, committed to the early diagnosis and treatment of adverse cardiac events. However, as current clinical management of cancer therapyrelated cardiovascular disease remains limited by a lack of phenotypic data, implementation of precision medicine approaches has become a focal point for deep phenotyping strategies. In particular, -omics approaches (a field of study in biology ending in -omic, such as genomics, proteomics, or metabolomics) have shown enormous potential in identifying sensitive biomarkers of cardiovascular disease, applying sophisticated, pattern-revealing technologies to growing databases of biologic molecules. Moreover, the use of -omics to inform radiologic strategies may add a dimension to future clinical practices. In this review, we present a paradigm for a precision medicine approach to the care of cardiotoxin-exposed cancer patients. We discuss the role of current imaging techniques; demonstrate how -omics can advance our understanding of disease phenotypes; and describe how molecular imaging can be integrated to personalize surveillance and therapeutics, ultimately reducing cardiovascular morbidity and mortality in cancer patients and survivors.

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When Left Ventricular Extracellular Volume Fraction Changes After Anthracyclines

Cited by 8 publications

References 9 publications

Cardiovascular Magnetic Resonance Imaging in the Early Detection of Cardiotoxicity Induced by Cancer Therapies

Cardiovascular Magnetic Resonance Imaging in the Early Detection of Cardiotoxicity Induced by Cancer Therapies

The Role of Cardiac MRI in Animal Models of Cardiotoxicity: Hopes and Challenges

Precision Cardio-Oncology

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