Abstract
Summary LV mass by CMR is a powerful predictor of adverse cardiovascular outcomes in patients treated with anthracyclines. Background Late gadolinium enhancement (LGE) is a predictor of adverse outcomes in patients. However, limited data exist on the role of LGE, the characteristic CMR findings, and the prognostic variables in patients who develop a cardiomyopathy after treatment with anthracyclines. Methods LGE-CMR imaging was performed in patients with stage B and C heart failure after anthracycline-based chemotherapy. We assessed the association between CMR, EKG, echocardiographic, serum, and clinical variables with adverse outcomes (cardiovascular death and admission for heart failure). Results We performed a clinically-indicated CMR study on 50 patients (52% male, mean age of 49 ± 16 years, anthracycline dose of 286 ± 89 mg/m2, and ejection fraction of 38 ± 9%) with AC-mediated cardiomyopathy. Patients presented a median of 45 months after chemotherapy and were followed for a median period of 28 months. LGE was an uncommon finding (3 patients, 6%). There was a strong inverse association between anthracycline dose and indexed left ventricular mass by CMR (r = -.75, p < 0.001, Figure 1). In univariate analysis, indexed LV-mass by CMR demonstrated the strongest unadjusted association with adverse events (hazard ratio: 0.75, chi-squared 26.2, p < 0.001). In a multivariable model, indexed LVmass demonstrated the strongest association with the primary outcome (Figure 2). Conclusions
Highlights
Late gadolinium enhancement (LGE) is a predictor of adverse outcomes in patients
Left ventricular mass by cardiac magnetic resonance imaging and adverse cardiovascular outcomes in patients treated with anthracyclinebased chemotherapy
Limited data exist on the role of LGE, the characteristic CMR findings, and the prognostic variables in patients who develop a cardiomyopathy after treatment with anthracyclines
Summary
Late gadolinium enhancement (LGE) is a predictor of adverse outcomes in patients. limited data exist on the role of LGE, the characteristic CMR findings, and the prognostic variables in patients who develop a cardiomyopathy after treatment with anthracyclines. Left ventricular mass by cardiac magnetic resonance imaging and adverse cardiovascular outcomes in patients treated with anthracyclinebased chemotherapy Tomas G Neilan1,2*, Diego Pena-Herrera2, Otavio R Coelho-Filho2, Michael Jerosch-Herold3, Javid Moslehi2, Raymond Kwong2 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA.
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