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

Matthew A. Lunning, Shelby Kutty, Eric T. Rome, Ling Li, Asif Padiyath, Fausto Loberiza, Robert Gregory Bociek, Philip J. Bierman, Julie M. Vose, James O. Armitage, Thomas R. Porter

Research output: Contribution to journalArticle

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
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Lunning, M. A., Kutty, S., Rome, E. T., Li, L., Padiyath, A., Loberiza, F., Bociek, R. G., Bierman, P. J., Vose, J. M., Armitage, J. O., & Porter, T. R. (2015). Cardiac Magnetic Resonance Imaging for the Assessment of the Myocardium after Doxorubicin-based Chemotherapy. American Journal of Clinical Oncology: Cancer Clinical Trials, 38(4), 377-381. https://doi.org/10.1097/COC.0b013e31829e19be