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首页> 外文期刊>ESC Heart Failure >Native myocardial T1 time can predict development of subsequent anthracycline‐induced cardiomyopathy
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Native myocardial T1 time can predict development of subsequent anthracycline‐induced cardiomyopathy

机译：原发性心肌T1时间可以预测随后蒽环类药物引起的心肌病的发展

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Aims This study aims to assess subclinical changes in functional and morphological myocardial magnetic resonance parameters very early into an anthracycline treatment, which may predict subsequent development of anthracycline‐induced cardiomyopathy (aCMP). Methods and results Thirty sarcoma patients with planned anthracycline‐based chemotherapy (360–400?mg/m 2 doxorubicin‐equivalent) were recruited. Median treatment time was 19.1?±?2.1?weeks. Enrolled individuals received three cardiovascular magnetic resonance studies (before treatment, 48?h after first anthracycline treatment, and upon completion of treatment). Native T1 mapping (modified Look–Locker inversion recovery 5s(3s)3s), T2 mapping, and extracellular volume maps were acquired in addition to a conventional cardiovascular magnetic resonance with steady‐state free precession cine imaging at 1.5?T. Patients were given 0.2?mmol/kg gadoteridol for extracellular volume quantification and late gadolinium enhancement imaging. Development of relevant aCMP was defined as drop of left ventricular ejection fraction (LVEF) by 10%. For analysis, 23 complete data sets were available. Nine patients developed aCMP with LVEF reduction 10% until end of chemotherapy. Baseline LVEF was not different between patients with and without subsequent aCMP. When assessed 48?h after first dose of antracyclines, patients with subsequent aCMP had significantly lower native myocardial T1 times compared with before therapy (1002.0?±?37.9 vs. 956.5?±?29.2?ms, P ??0.01) than patients who did not develop aCMP (990.9?±?56.4 vs. 978.4?±?57.4?ms, P ??0.05). Patients with aCMP had decreased left ventricular mass upon completion of therapy (86.9?±?24.5 vs. 81.1?±?22.3?g; P ?=?0.02), while patients without aCMP did not show a change in left ventricular mass (81.8?±?21.0 vs. 79.2?±?18.1?g; P ??0.05). No patient developed new myocardial scars or compact myocardial fibrosis under chemotherapy. Conclusions Early decrease of T1 times 48?h after first treatment with anthracyclines can predict the development of subsequent aCMP after completion of chemotherapy.
机译：目的本研究旨在评估蒽环类药物治疗早期的功能性和形态学心肌磁共振参数的亚临床变化，这可能预测蒽环类药物引起的心肌病（aCMP）的后续发展。方法和结果招募了30名计划进行蒽环类化疗的肉瘤患者（360-400？mg / m 2阿霉素当量）。中位治疗时间为19.1±2.1周。入组的个人接受了三项心血管磁共振研究（治疗前，第一次蒽环类药物治疗后48h和治疗完成后）。除了传统的心血管磁共振，在1.5？T的稳态自由进动电影成像之外，还获得了天然T1映射（改良的Look-Locker反转恢复5s（3s）3s），T2映射和细胞外体积图。给予患者0.2？mmol / kg gadoteridol进行细胞外体积定量和晚期enhancement增强显像。相关aCMP的发生定义为左心室射血分数（LVEF）下降> 10％。为了分析，提供了23个完整的数据集。直到化疗结束前，有9名患者出现了aCMP，LVEF降低> 10％。基线LVEF在有无后续aCMP的患者之间没有差异。在首次服用抗环素类药物48小时后评估，随后aCMP的患者的天然心肌T1时间比治疗前显着降低（1002.0±±37.9 vs. 956.5±±29.2μms，P≤0.01）。谁没有发展出aCMP（990.9？±？56.4 vs. 978.4？±？57.4？ms，P？>？0.05）。完成治疗后，患有aCMP的患者左心室质量减少（86.9±±24.5 vs. 81.1±±22.3μg;P≥0.02），而没有aCMP的患者左心室质量无变化（81.8）。 α±21.0 vs.79.2±±18.1μg;P≥0.05。化疗后没有患者出现新的心肌疤痕或紧凑型心肌纤维化。结论蒽环类药物首次治疗后48h的T1早期降低可以预测化疗完成后随后aCMP的发生。

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