Meng-Xi Yang1,2,3, Qing-Li Li4, Dan-Qing Wang4, Lu Ye5, Ke-Min Li4, Xiao-Juan Lin4, Xue-Sheng Li2, Chuan Fu2, Xin-Mao Ma2, Ying-Kun Guo2, Ru-Tie Yin6, Zhi-Gang Yang7. 1. Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan, China. 2. Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China. 3. Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. 4. Department of Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China. 5. Department of Ultrasound, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China. 6. Department of Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China. yrtt2013@163.com. 7. Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan, China. yangzg666@163.com.
Abstract
OBJECTIVES: Cancer chemotherapy potentially increases the risk of myocardial ischemia. This study assessed myocardial microvascular function by cardiac magnetic resonance (CMR) first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies. METHODS: A total of 81 patients treated with chemotherapy for gynecologic malignancies and 39 healthy volunteers were prospectively enrolled and underwent CMR imaging. Among the patients, 32 completed CMR follow-up, with a median interval of 6 months. The CMR sequences comprised cardiac cine, rest first-pass perfusion, and late gadolinium enhancement. RESULTS: There were no significant differences in the baseline characteristics between the patients and normal controls (all p > 0.05). Compared with the normal controls, the patients had a lower myocardial perfusion index (PI) (13.62 ± 2.01% vs. 12% (11 to 14%), p = 0.001) but demonstrated no significant variation with an increase in the number of chemotherapy cycles at follow-up (11.79 ± 2.36% vs. 11.19 ± 2.19%, p = 0.234). In multivariate analysis with adjustments for clinical confounders, a decrease in the PI was independently associated with chemotherapy treatment (β = - 0.362, p = 0.002) but had no correlation with the number of chemotherapy cycles (r = - 0.177, p = 0.053). CONCLUSION: Myocardial microvascular dysfunction was associated with chemotherapy treatment in patients with gynecologic malignancies, and can be assessed and monitored by rest CMR first-pass perfusion. KEY POINTS: • Chemotherapy was associated with but did not aggravate myocardial microvascular dysfunction in patients with gynecologic malignancies. • Rest CMR first-pass perfusion is an ideal modality for assessing and monitoring alterations in myocardial microcirculation during chemotherapy treatment.
OBJECTIVES: Cancer chemotherapy potentially increases the risk of myocardial ischemia. This study assessed myocardial microvascular function by cardiac magnetic resonance (CMR) first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies. METHODS: A total of 81 patients treated with chemotherapy for gynecologic malignancies and 39 healthy volunteers were prospectively enrolled and underwent CMR imaging. Among the patients, 32 completed CMR follow-up, with a median interval of 6 months. The CMR sequences comprised cardiac cine, rest first-pass perfusion, and late gadolinium enhancement. RESULTS: There were no significant differences in the baseline characteristics between the patients and normal controls (all p > 0.05). Compared with the normal controls, the patients had a lower myocardial perfusion index (PI) (13.62 ± 2.01% vs. 12% (11 to 14%), p = 0.001) but demonstrated no significant variation with an increase in the number of chemotherapy cycles at follow-up (11.79 ± 2.36% vs. 11.19 ± 2.19%, p = 0.234). In multivariate analysis with adjustments for clinical confounders, a decrease in the PI was independently associated with chemotherapy treatment (β = - 0.362, p = 0.002) but had no correlation with the number of chemotherapy cycles (r = - 0.177, p = 0.053). CONCLUSION: Myocardial microvascular dysfunction was associated with chemotherapy treatment in patients with gynecologic malignancies, and can be assessed and monitored by rest CMR first-pass perfusion. KEY POINTS: • Chemotherapy was associated with but did not aggravate myocardial microvascular dysfunction in patients with gynecologic malignancies. • Rest CMR first-pass perfusion is an ideal modality for assessing and monitoring alterations in myocardial microcirculation during chemotherapy treatment.
Authors: Jose Luis Zamorano; Patrizio Lancellotti; Daniel Rodriguez Muñoz; Victor Aboyans; Riccardo Asteggiano; Maurizio Galderisi; Gilbert Habib; Daniel J Lenihan; Gregory Y H Lip; Alexander R Lyon; Teresa Lopez Fernandez; Dania Mohty; Massimo F Piepoli; Juan Tamargo; Adam Torbicki; Thomas M Suter; Jose Luis Zamorano; Victor Aboyans; Stephan Achenbach; Stefan Agewall; Lina Badimon; Gonzalo Barón-Esquivias; Helmut Baumgartner; Jeroen J Bax; Héctor Bueno; Scipione Carerj; Veronica Dean; Çetin Erol; Donna Fitzsimons; Oliver Gaemperli; Paulus Kirchhof; Philippe Kolh; Patrizio Lancellotti; Gregory Y H Lip; Petros Nihoyannopoulos; Massimo F Piepoli; Piotr Ponikowski; Marco Roffi; Adam Torbicki; António Vaz Carneiro; Stephan Windecker Journal: Eur J Heart Fail Date: 2016-08-27 Impact factor: 15.534
Authors: Anne Bethke; Limalanathan Shanmuganathan; Geir Øystein Andersen; Jan Eritsland; David Swanson; Nils Einar Kløw; Pavel Hoffmann Journal: Eur Radiol Date: 2018-07-06 Impact factor: 5.315
Authors: M T Meinardi; J A Gietema; W T van der Graaf; D J van Veldhuisen; M A Runne; W J Sluiter; E G de Vries; P B Willemse; N H Mulder; M P van den Berg; H S Koops; D T Sleijfer Journal: J Clin Oncol Date: 2000-04 Impact factor: 44.544
Authors: A Chiribiri; S Leuzzi; M R Conte; S Bongioanni; K Bratis; L Olivotti; C De Rosa; E Lardone; P Di Donna; A D M Villa; F Cesarani; E Nagel; F Gaita; R Bonamini Journal: Clin Radiol Date: 2015-02-07 Impact factor: 2.350