Early Myocardial Oedema can Predict Subsequent Cardiomyopathy in High-Dose Anthracycline Therapy
Authors' conclusion
With high cumulative anthracycline doses, early increase of T2 times 48 h after first treatment with anthracyclines can predict the development of subsequent aCMP after completion of chemotherapy. Early drop of native T1 times occurs irrespective of development of aCMP in high-dose anthracycline therapy.
Study context
- Population
- Sarcoma patients previously exposed to 300–360 mg/m² doxorubicin-equivalent, planned for a second anthracycline course (360 mg/m² doxorubicin-equivalent); CMR before, 48 h after first dose and at completion23 complete datasets analysed
- Participants
- 30 participants
- Exposure
- Patients with vs without subsequent anthracycline-induced cardiomyopathy
- aCMPn = 8
- Outcome
- Myocardial T2 time, before therapy vs 48 h after first anthracycline dose
- Follow-up
- 48 h after first dose
Methodological detailsMedian treatment time 20.7 ± 3.0 weeks
- Median treatment time 20.7 ± 3.0 weeks
Main finding
As reported in the abstract
| Group | T2 at 48 h vs before |
|---|---|
| aCMP | 53.0 ± 2.8 ms vs. 49.3 ± 5.2 ms, P = 0.02 |
| non-aCMP | 50.7 ± 5.1 ms vs. 51.1 ± 3.9 ms, P > 0.05 |
T2 at 48 h vs before
aCMP53.0 ± 2.8 ms vs. 49.3 ± 5.2 ms, P = 0.02
non-aCMP50.7 ± 5.1 ms vs. 51.1 ± 3.9 ms, P > 0.05
Observational data: associations, not effects.
Further findings
| Outcome | aCMP | non-aCMP |
|---|---|---|
| LV mass, completion vs baseline · completion of therapy | ||
| LV mass | 99.4 ± 26.5 g vs. 90.3 ± 24.8 g; P = 0.02 | 91.5 ± 20.0 g vs. 89.0 ± 23.6 g; P > 0.05 |
| Strain (GLS, GCS), completion vs baseline · completion of therapy | ||
| GLS | −15.3 ± 1.3 vs. −13.4 ± 1.6; P = 0.02 | −15.4 ± 3.3 vs. −15.4 ± 3.4; P = 0.97 |
| GCS | −16.7 ± 2.1 vs. −14.9 ± 2.6; P = 0.04 | — not stated in the abstract |
| Native T1, completion vs baseline · completion of therapy | ||
| Native T1 | 1050.8 ± 17.9 ms vs. 1022.4 ± 22.0 ms; P = 0.01 | 1034.5 ± 46.6 ms vs. 1018.4 ± 29.7 ms; P = 0.15 |
— not stated in the abstract
Native T1 at 48 h after first dose (all patients)
- Native T1 decreased irrespective of subsequent aCMP
- 1020.2 ± 28.4 ms vs. 973.5 ± 40.3 ms
Baseline left ventricular ejection fraction (LVEF); new scars/fibrosis; cardiac biomarkers
- Baseline LVEF not different between aCMP and non-aCMP
- No patient developed new myocardial scars or compact fibrosis
- Cardiac biomarkers elevated independent of aCMP
Original publication
Early Myocardial Oedema can Predict Subsequent Cardiomyopathy in High-Dose Anthracycline Therapy. ESC Heart Fail. Published 20 November 2022. doi:10.
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