CardiomyopathyMyocardial Extracellular Volume by Cardiac Magnetic Resonance Imaging in Patients Treated With Anthracycline-Based Chemotherapy
Section snippets
Methods
The institutional human subjects review committee of our institution approved the protocol. We performed an observational study of patients with previous anthracycline treatment who had been referred for a clinically indicated CMR study from 2010 to 2012. Healthy controls for the CMR measures were recruited by open invitation. The requirements for inclusion were a history of anthracycline treatment, sinus rhythm, and the absence of an alternate pathologic etiology for myocardial ECV expansion.
Results
We studied 42 patients with previous anthracycline-based chemotherapy (Table 1). Of the 42 patients, 9 had Hodgkin's lymphoma, 17 had non-Hodgkin's lymphoma, 7 had breast cancer, 5 had leukemia, and 4 had bone cancer. Also, 2 patients had received liposomal doxorubicin and 2 trastuzumab. We separated the anthracycline-treated group according to whether the EF was preserved (n = 28) or reduced (n = 14). The preserved EF group was referred for a CMR study before ablation of atrial fibrillation
Discussion
We measured the myocardial ECV in patients with previous anthracycline treatment. The ECV was increased in patients compared to that in the healthy controls. The ECV was elevated in patients treated with anthracyclines and presenting with heart failure with both a reduced and a preserved EF. A direct association was found between the ECV and the left atrial volume and noninvasively estimated left atrial pressure, with an inverse association found with diastolic function.
MF, as assessed using
Disclosures
The authors have no conflicts of interest to disclose.
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This work was supported in part by Fellow to Faculty grant 12FTF12060588 from the American Heart Association (Dallas, Texas), T32 Training grant T32 HL094301-02 (to T. G. Neilan) from the National Institutes of Health (Bethesda, Maryland), Health Career Development grant K08HL097031-02) (to J. Moslehi) from the National Institutes of Health, and project grants R01HL090634-01A1 (to M. Jerosch-Herold) and R01HL091157 (to R. Y. Kwong).
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