Browse/search for people

Publication - Dr Giovanni Biglino

    Long term cardiovascular magnetic resonance phenotyping of anthracycline cardiomyopathy

    Citation

    Harries, I, Biglino, G, Baritussio, A, De Garate, E, Dastidar, AG, Plana, JC & Bucciarelli-Ducci, C, 2019, ‘Long term cardiovascular magnetic resonance phenotyping of anthracycline cardiomyopathy’. International Journal of Cardiology, vol 292., pp. 248-252

    Abstract

    Background

    Anthracycline cardiomyopathy contributes to the morbidity
    and mortality of cancer survivors but long-term data are lacking. This
    study sought to describe the phenotype of long-term anthracycline
    cardiomyopathy, the prevalence of myocardial fibrosis and its association with cardiac remodeling, systolic function and clinical outcomes.

    Methods and results

    We undertook contrast-enhanced CMR in 81 cancer survivors at median 5 years after anthracycline (mean dose 279 SD 89 mg/m2).
    Participants were aged 55 SD 14 years; 68% were female. Mean LVEF was
    impaired (49 SD 12%), driven by a pathological increase in iLVESV (47 SD
    23 ml/m2). 19% of participants exhibited LGE, which was
    associated with significant adverse left ventricular remodeling and
    reduced systolic function (iLVEDV: 102 SD 34 vs 83 SD 21 ml/m2, p = 0.03; iLVESV 61 SD 32 vs 43 SD 20 ml/m2, p = 0.03; LVEF: 43 SD 11 vs 50 SD 12%, p = 0.03). In subgroup analysis
    of 36 patients, 36% had elevated native T1 measurements, which was
    associated with significant adverse left ventricular remodeling (iLVEDV:
    97 SD 22 vs 74 SD 19 ml/m2, p = 0.002; iLVESV: 56 SD 22 vs 35 SD 15 ml/m2, p = 0.005), reduced systolic function (LVEF 44 SD 13 vs 55 SD 9%, p = 0.01), and hospitalizations for heart failure (38% vs 9%, p = 0.03). Absolute native T1 measurements correlated significantly with iLVEDV (p ≤ 0.001, R2 0.33), iLVESV (p < 0.001, R2 0.36), LVEF (p < 0.001, R2 0.35), LAVi (p = 0.04, R2 0.12) and MAPSE (p = 0.02, R2 0.14).

    Conclusions

    Long-term
    anthracycline cardiomyopathy is characterized by pathologically
    increased iLVESV. Both LGE and elevated native T1 measurements were
    associated with significant adverse cardiac remodeling and reduced
    systolic function, and the latter with heart failure hospitalizations.

    Full details in the University publications repository