Abstract

Objectives: Doxorubicin is associated with a cumulative dose-dependent nonischemic cardiomyopathy. Cardiac magnetic resonance imaging (cMRI) is able to examine both structural and functional components of the myocardium. Our aim was to assess the myocardial changes in non-Hodgkin lymphoma patients undergoing doxorubicin-based chemotherapy using cMRI. Materials and Methods: cMRI examination was performed before and 3 months after chemotherapy. Experienced investigators interpreted each cMRI, and were blinded to all data. Left ventricular ejection fractions (LVEF), cardiac deformation, and delayed gadolinium enhancement (GD-DE) were quantified for each cMRI. The change between LVEF, GD-GE, and cardiac deformation parameters were compared between the 2 cMRI studies. A Δ LVEF≥10% was considered clinically relevant. The findings of GD-GE or changes in myocardial strain were analyzed as independent variables. Results: All 10 patients enrolled received a cumulative dose of doxorubicin of 300 mg/m 2. A comparison of pretreatment and posttreatment cMRI demonstrated 5 (50%) patients with a ≥10% decrease in LVEF (median, -8.4%; range, 1% to -17%; P=0.004). Three patients had at least 1 new or progressive segment of GD-DE. The global circumferential strain was significantly lower in patients after treatment, as compared with values before treatment (P=0.018) and to normal controls (P=0.046). Patients after treatment also had significantly lower global longitudinal strain than controls (P=0.035), and longitudinal strain values that tended to decrease compared with pretreatment values (P=0.073). Discussion: Our data suggests that cMRI has the ability to assess both early structural and functional myocardial changes in association with doxorubicin-based chemotherapy.

Original languageEnglish (US)
Pages (from-to)377-381
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume38
Issue number4
DOIs
StatePublished - Aug 6 2015

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Doxorubicin
Myocardium
Magnetic Resonance Imaging
Drug Therapy
Stroke Volume
Gadolinium
Cardiomyopathies
Non-Hodgkin's Lymphoma
Therapeutics
Research Personnel

Keywords

  • anthracycline
  • cardiac magnetic resonance imaging
  • cardiomyopathy
  • doxorubicin
  • lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{4af61b831295443f8a4c14f478ed341b,
title = "Cardiac Magnetic Resonance Imaging for the Assessment of the Myocardium after Doxorubicin-based Chemotherapy",
abstract = "Objectives: Doxorubicin is associated with a cumulative dose-dependent nonischemic cardiomyopathy. Cardiac magnetic resonance imaging (cMRI) is able to examine both structural and functional components of the myocardium. Our aim was to assess the myocardial changes in non-Hodgkin lymphoma patients undergoing doxorubicin-based chemotherapy using cMRI. Materials and Methods: cMRI examination was performed before and 3 months after chemotherapy. Experienced investigators interpreted each cMRI, and were blinded to all data. Left ventricular ejection fractions (LVEF), cardiac deformation, and delayed gadolinium enhancement (GD-DE) were quantified for each cMRI. The change between LVEF, GD-GE, and cardiac deformation parameters were compared between the 2 cMRI studies. A Δ LVEF≥10{\%} was considered clinically relevant. The findings of GD-GE or changes in myocardial strain were analyzed as independent variables. Results: All 10 patients enrolled received a cumulative dose of doxorubicin of 300 mg/m 2. A comparison of pretreatment and posttreatment cMRI demonstrated 5 (50{\%}) patients with a ≥10{\%} decrease in LVEF (median, -8.4{\%}; range, 1{\%} to -17{\%}; P=0.004). Three patients had at least 1 new or progressive segment of GD-DE. The global circumferential strain was significantly lower in patients after treatment, as compared with values before treatment (P=0.018) and to normal controls (P=0.046). Patients after treatment also had significantly lower global longitudinal strain than controls (P=0.035), and longitudinal strain values that tended to decrease compared with pretreatment values (P=0.073). Discussion: Our data suggests that cMRI has the ability to assess both early structural and functional myocardial changes in association with doxorubicin-based chemotherapy.",
keywords = "anthracycline, cardiac magnetic resonance imaging, cardiomyopathy, doxorubicin, lymphoma",
author = "Lunning, {Matthew A} and Shelby Kutty and Rome, {Eric T.} and Ling Li and Asif Padiyath and Fausto Loberiza and Bociek, {Robert G} and Bierman, {Philip Jay} and Vose, {Julie Marie} and Armitage, {James Olen} and Porter, {Thomas Richard}",
year = "2015",
month = "8",
day = "6",
doi = "10.1097/COC.0b013e31829e19be",
language = "English (US)",
volume = "38",
pages = "377--381",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Cardiac Magnetic Resonance Imaging for the Assessment of the Myocardium after Doxorubicin-based Chemotherapy

AU - Lunning, Matthew A

AU - Kutty, Shelby

AU - Rome, Eric T.

AU - Li, Ling

AU - Padiyath, Asif

AU - Loberiza, Fausto

AU - Bociek, Robert G

AU - Bierman, Philip Jay

AU - Vose, Julie Marie

AU - Armitage, James Olen

AU - Porter, Thomas Richard

PY - 2015/8/6

Y1 - 2015/8/6

N2 - Objectives: Doxorubicin is associated with a cumulative dose-dependent nonischemic cardiomyopathy. Cardiac magnetic resonance imaging (cMRI) is able to examine both structural and functional components of the myocardium. Our aim was to assess the myocardial changes in non-Hodgkin lymphoma patients undergoing doxorubicin-based chemotherapy using cMRI. Materials and Methods: cMRI examination was performed before and 3 months after chemotherapy. Experienced investigators interpreted each cMRI, and were blinded to all data. Left ventricular ejection fractions (LVEF), cardiac deformation, and delayed gadolinium enhancement (GD-DE) were quantified for each cMRI. The change between LVEF, GD-GE, and cardiac deformation parameters were compared between the 2 cMRI studies. A Δ LVEF≥10% was considered clinically relevant. The findings of GD-GE or changes in myocardial strain were analyzed as independent variables. Results: All 10 patients enrolled received a cumulative dose of doxorubicin of 300 mg/m 2. A comparison of pretreatment and posttreatment cMRI demonstrated 5 (50%) patients with a ≥10% decrease in LVEF (median, -8.4%; range, 1% to -17%; P=0.004). Three patients had at least 1 new or progressive segment of GD-DE. The global circumferential strain was significantly lower in patients after treatment, as compared with values before treatment (P=0.018) and to normal controls (P=0.046). Patients after treatment also had significantly lower global longitudinal strain than controls (P=0.035), and longitudinal strain values that tended to decrease compared with pretreatment values (P=0.073). Discussion: Our data suggests that cMRI has the ability to assess both early structural and functional myocardial changes in association with doxorubicin-based chemotherapy.

AB - Objectives: Doxorubicin is associated with a cumulative dose-dependent nonischemic cardiomyopathy. Cardiac magnetic resonance imaging (cMRI) is able to examine both structural and functional components of the myocardium. Our aim was to assess the myocardial changes in non-Hodgkin lymphoma patients undergoing doxorubicin-based chemotherapy using cMRI. Materials and Methods: cMRI examination was performed before and 3 months after chemotherapy. Experienced investigators interpreted each cMRI, and were blinded to all data. Left ventricular ejection fractions (LVEF), cardiac deformation, and delayed gadolinium enhancement (GD-DE) were quantified for each cMRI. The change between LVEF, GD-GE, and cardiac deformation parameters were compared between the 2 cMRI studies. A Δ LVEF≥10% was considered clinically relevant. The findings of GD-GE or changes in myocardial strain were analyzed as independent variables. Results: All 10 patients enrolled received a cumulative dose of doxorubicin of 300 mg/m 2. A comparison of pretreatment and posttreatment cMRI demonstrated 5 (50%) patients with a ≥10% decrease in LVEF (median, -8.4%; range, 1% to -17%; P=0.004). Three patients had at least 1 new or progressive segment of GD-DE. The global circumferential strain was significantly lower in patients after treatment, as compared with values before treatment (P=0.018) and to normal controls (P=0.046). Patients after treatment also had significantly lower global longitudinal strain than controls (P=0.035), and longitudinal strain values that tended to decrease compared with pretreatment values (P=0.073). Discussion: Our data suggests that cMRI has the ability to assess both early structural and functional myocardial changes in association with doxorubicin-based chemotherapy.

KW - anthracycline

KW - cardiac magnetic resonance imaging

KW - cardiomyopathy

KW - doxorubicin

KW - lymphoma

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U2 - 10.1097/COC.0b013e31829e19be

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JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

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