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Cardiac MRI: a Promising Diagnostic Tool to Detect Cancer Therapeutics–Related Cardiac Dysfunction

  • Cardiac Magnetic Resonance (E Nagel and V Puntmann, Section Editors)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Recent advances in oncological research have led to a major improvement of mortality amongst cancer patients. However, survivors are at an increased risk to develop cancer therapeutics–related cardiac dysfunction (CTRCD). The management of CTRCD may pose a challenge due to its heterogeneous clinical presentation. This warrants the need for a multi-modality diagnostic tool to objectively acquire prognostic information for timely commencement of cardio-protective treatment. Cardiac magnetic resonance (CMR) imaging offers considerable potential due to its non-invasive, reproducible protocol. Moreover, biomarkers such as T1 and T2 mapping allow discrimination between oedematous and fibrotic myocardium, providing an invaluable diagnostic algorithm to track the temporal evolution of CTRCD.

Recent Findings

In this review, we appraise current evidence for the role of CMR in the management of CTRCD, placing emphasis on ventricular function, strain, late gadolinium enhancement and parametric mapping.

Summary

We recommend a central role for CMR in the interdisciplinary management of CTRCD.

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Abbreviations

2/3DE:

2D/3D echocardiography

AI:

Artificial intelligence

ATP:

Adenosine triphosphate

CMR:

Cardiac magnetic resonance

CTLA-4:

Cytotoxic T lymphocyte–associated Protein 4

CTRCD:

Cancer therapeutics–related cardiac dysfunction

CV:

Cardiovascular

ECV:

Extracellular volume

EDV:

End-diastolic volume

ESV:

End-systolic volume

EMB:

Endomyocardial biopsy

ESC:

European Society of Cardiology

GCS:

Global circumferential strain

GLS:

Global longitudinal strain

HF:

Heart failure

hs-troponinT:

High-sensitive troponin T

LGE:

Late gadolinium enhancement

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

NT-proBNP:

N-terminal pro-brain natriuretic peptide

NSCLC:

Non-small cell lung cancer

PD1:

Programmed cell death protein 1

PDL1:

Programmed cell death protein ligand 1

PWV:

Pulse wave velocity

QOL:

Quality of life

ROS:

Reactive oxygen species

RVEF:

Right ventricular ejection fraction

SSFP:

Steady-state free precession

TKI:

Tyrosine kinase inhibitors

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Authors and Affiliations

  1. Institute of Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt, Germany

    Jasmin D. Haslbauer, Eike Nagel & Valentina O. Puntmann

  2. Department of Haematology and Oncology, Goethe University Hospital Frankfurt, Frankfurt, Germany

    Sarah Lindner & Gesine Bug

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  1. Jasmin D. Haslbauer
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Jasmin D. Haslbauer, Gesine Bug, Eike Nagel and Valentina O. Puntmann declare that they have no conflict of interest.

Sarah Lindner receives travel support from Celgene, Sanofi and Neovii.

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Haslbauer, J.D., Lindner, S., Bug, G. et al. Cardiac MRI: a Promising Diagnostic Tool to Detect Cancer Therapeutics–Related Cardiac Dysfunction. Curr Cardiovasc Imaging Rep 12, 18 (2019). https://doi.org/10.1007/s12410-019-9489-1

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