Cardiac Magnetic Resonance Imaging for the Assessment of Anthracycline-Induced Cardiotoxicity
Kang Sang
Hu Haiyan
Li Hongtao
Liu Yuting
Xiao Huoyuan
Danzeng Quyang
Li Xinni
Pan Jingwei
Abstract：Objective To investigate the value of cardiac magnetic resonance imaging(CMR)in assessing anthracycline-induced cardiotoxicity.Methods A total of 105 patients with bone and soft tissue sarcoma(BSTS)from the oncology department of Shanghai Sixth People's Hospital were sequentially enrolled from March 2023 to December 2023.All patients underwent a CMR examination and were divided into three groups based on their chemotherapy status:the non-chemotherapy group(no chemotherapy,n=45),the low-dose group(anthracycline cumulative dose≤250 mg,n=30),and the high-dose group(anthracycline cumulative dose>250 mg,n=30).CMR images were analyzed using CVI42 post-processing software to assess conventional cardiac function parameters and left ventricular global strain indices,including left ventricular ejection fraction(LVEF),left atrioventricular coupling index(LACI),global longitudinal strain(GLS),global circumferential strain(GCS),and global radial strain(GRS).Results Compared to the non-chemotherapy and low-dose groups,the high-dose group demonstrated significantly reduced myocardial strain indices,namely GLS,GCS,and GRS(all P<0.05),while no significant differences were observed in LVEF among the three groups(P=0.092).The LACI values were significantly increased in the low-dose and high-dose groups compared to the non-chemotherapy group,with the most pronounced increase seen in the low-dose group(P=0.002).Linear regression analysis revealed that the cumulative anthracycline dose had a significant impact on GLS,GCS,and GRS(GLS:β=-0.004,P<0.001;GCS:β=-0.008,P=0.005;GRS:β=-0.003,P=0.003).With an increase in cumulative anthracycline dose,there was a corresponding decrease in GLS,GCS,and GRS.Conclusion CMR-derived myocardial strain effectively detects early cardiac injury induced by anthracyclines.Increasing cumulative doses of anthracyclines correlate with greater cardiac damage.LACI may be a potential indicator for cardiotoxicity monitoring with clinical relevance.
Keywords：Anthracycline-cardiac injuryMyocardial strainCMRLACI
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 322-326 )