Left Ventricular Mass in Patients With a Cardiomyopathy After Treatment With Anthracyclines
We aimed to describe the cardiac magnetic resonance (CMR) findings and determine the prognostic variables in patients with a cardiomyopathy after treatment with anthracyclines. CMR imaging was performed in 91 patients (58% men, mean age 43 ± 18 years, and mean anthracycline dose of 276 ± 82 mg/m2 )...
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| Veröffentlicht in: | The American journal of cardiology 2012-12, Vol.110 (11), p.1679-1686 |
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| container_title | The American journal of cardiology |
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| creator | Neilan, Tomas G., MD Coelho-Filho, Otavio R., MD, MPH Pena-Herrera, Diego Shah, Ravi V., MD Jerosch-Herold, Michael, PhD Francis, Sanjeev A., MD Moslehi, Javid, MD Kwong, Raymond Y., MD, MPH |
| description | We aimed to describe the cardiac magnetic resonance (CMR) findings and determine the prognostic variables in patients with a cardiomyopathy after treatment with anthracyclines. CMR imaging was performed in 91 patients (58% men, mean age 43 ± 18 years, and mean anthracycline dose of 276 ± 82 mg/m2 ) with a reduced ejection fraction after anthracycline-based chemotherapy. Major adverse cardiovascular events were defined as cardiovascular death, appropriate implantable cardioverter-defibrillator therapy, and admission for decompensated heart failure. Patients presented a median of 88 months (interquartile range 37 to 138) after chemotherapy and were followed for 27 months (interquartile range 22 to 38). Late gadolinium enhancement was an uncommon finding (5 patients, 6%) despite a reduced ejection fraction (36 ± 8%). An inverse association was found between the anthracycline dose and the indexed left ventricular (LV) mass by CMR (r = −0.67, p |
| doi_str_mv | 10.1016/j.amjcard.2012.07.040 |
| format | Article |
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CMR imaging was performed in 91 patients (58% men, mean age 43 ± 18 years, and mean anthracycline dose of 276 ± 82 mg/m2 ) with a reduced ejection fraction after anthracycline-based chemotherapy. Major adverse cardiovascular events were defined as cardiovascular death, appropriate implantable cardioverter-defibrillator therapy, and admission for decompensated heart failure. Patients presented a median of 88 months (interquartile range 37 to 138) after chemotherapy and were followed for 27 months (interquartile range 22 to 38). Late gadolinium enhancement was an uncommon finding (5 patients, 6%) despite a reduced ejection fraction (36 ± 8%). An inverse association was found between the anthracycline dose and the indexed left ventricular (LV) mass by CMR (r = −0.67, p <0.001). A total of 52 adverse cardiac events occurred (event rate of 22%/year). When the patients were grouped according to the presence or absence of a major adverse cardiovascular event, the indexed LV mass and glomerular filtration rate were lower and the anthracycline dose was greater among the patients who experienced an adverse event. In a multivariate model, the indexed LV mass demonstrated the strongest association with major adverse cardiovascular events (hazard ratio 0.89, chi-square 26, p <0.001). In conclusion, myocardial scar by late gadolinium enhancement-CMR is infrequent in patients with anthracycline-cardiomyopathy despite a reduced ejection fraction, the event rate in patients with established anthracycline-cardiotoxicity is high, and indexed LV mass by CMR imaging is a predictor of adverse cardiovascular events.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2012.07.040</identifier><identifier>PMID: 22917553</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Anthracyclines - adverse effects ; Anthracyclines - therapeutic use ; Biological and medical sciences ; Biomarkers ; Cardiology. Vascular system ; Cardiomyopathies - chemically induced ; Cardiomyopathies - diagnosis ; Cardiomyopathies - physiopathology ; Cardiovascular ; Cardiovascular disease ; Chemotherapy ; Confidence intervals ; Coronary vessels ; Female ; Heart ; Heart attacks ; Heart Ventricles - pathology ; Humans ; Magnetic Resonance Imaging, Cine - methods ; Male ; Medical sciences ; Methods ; Mortality ; Myocarditis. Cardiomyopathies ; Neoplasms - drug therapy ; Prognosis ; Pulmonary arteries ; Stroke Volume - drug effects ; Womens health</subject><ispartof>The American journal of cardiology, 2012-12, Vol.110 (11), p.1679-1686</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><rights>2012 Excerpta Medica, Inc. All rights reserved. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c613t-b9b163a56fc9f58b48324d7a872f7c4a4bd0a7eefcfd12b7906722ec166525e13</citedby><cites>FETCH-LOGICAL-c613t-b9b163a56fc9f58b48324d7a872f7c4a4bd0a7eefcfd12b7906722ec166525e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914912018619$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26673889$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22917553$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neilan, Tomas G., MD</creatorcontrib><creatorcontrib>Coelho-Filho, Otavio R., MD, MPH</creatorcontrib><creatorcontrib>Pena-Herrera, Diego</creatorcontrib><creatorcontrib>Shah, Ravi V., MD</creatorcontrib><creatorcontrib>Jerosch-Herold, Michael, PhD</creatorcontrib><creatorcontrib>Francis, Sanjeev A., MD</creatorcontrib><creatorcontrib>Moslehi, Javid, MD</creatorcontrib><creatorcontrib>Kwong, Raymond Y., MD, MPH</creatorcontrib><title>Left Ventricular Mass in Patients With a Cardiomyopathy After Treatment With Anthracyclines</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>We aimed to describe the cardiac magnetic resonance (CMR) findings and determine the prognostic variables in patients with a cardiomyopathy after treatment with anthracyclines. CMR imaging was performed in 91 patients (58% men, mean age 43 ± 18 years, and mean anthracycline dose of 276 ± 82 mg/m2 ) with a reduced ejection fraction after anthracycline-based chemotherapy. Major adverse cardiovascular events were defined as cardiovascular death, appropriate implantable cardioverter-defibrillator therapy, and admission for decompensated heart failure. Patients presented a median of 88 months (interquartile range 37 to 138) after chemotherapy and were followed for 27 months (interquartile range 22 to 38). Late gadolinium enhancement was an uncommon finding (5 patients, 6%) despite a reduced ejection fraction (36 ± 8%). An inverse association was found between the anthracycline dose and the indexed left ventricular (LV) mass by CMR (r = −0.67, p <0.001). A total of 52 adverse cardiac events occurred (event rate of 22%/year). When the patients were grouped according to the presence or absence of a major adverse cardiovascular event, the indexed LV mass and glomerular filtration rate were lower and the anthracycline dose was greater among the patients who experienced an adverse event. In a multivariate model, the indexed LV mass demonstrated the strongest association with major adverse cardiovascular events (hazard ratio 0.89, chi-square 26, p <0.001). In conclusion, myocardial scar by late gadolinium enhancement-CMR is infrequent in patients with anthracycline-cardiomyopathy despite a reduced ejection fraction, the event rate in patients with established anthracycline-cardiotoxicity is high, and indexed LV mass by CMR imaging is a predictor of adverse cardiovascular events.</description><subject>Adult</subject><subject>Anthracyclines - adverse effects</subject><subject>Anthracyclines - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomyopathies - chemically induced</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathies - physiopathology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Chemotherapy</subject><subject>Confidence intervals</subject><subject>Coronary vessels</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Ventricles - pathology</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Mortality</subject><subject>Myocarditis. 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Vascular system</topic><topic>Cardiomyopathies - chemically induced</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathies - physiopathology</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Chemotherapy</topic><topic>Confidence intervals</topic><topic>Coronary vessels</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart Ventricles - pathology</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Mortality</topic><topic>Myocarditis. 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CMR imaging was performed in 91 patients (58% men, mean age 43 ± 18 years, and mean anthracycline dose of 276 ± 82 mg/m2 ) with a reduced ejection fraction after anthracycline-based chemotherapy. Major adverse cardiovascular events were defined as cardiovascular death, appropriate implantable cardioverter-defibrillator therapy, and admission for decompensated heart failure. Patients presented a median of 88 months (interquartile range 37 to 138) after chemotherapy and were followed for 27 months (interquartile range 22 to 38). Late gadolinium enhancement was an uncommon finding (5 patients, 6%) despite a reduced ejection fraction (36 ± 8%). An inverse association was found between the anthracycline dose and the indexed left ventricular (LV) mass by CMR (r = −0.67, p <0.001). A total of 52 adverse cardiac events occurred (event rate of 22%/year). When the patients were grouped according to the presence or absence of a major adverse cardiovascular event, the indexed LV mass and glomerular filtration rate were lower and the anthracycline dose was greater among the patients who experienced an adverse event. In a multivariate model, the indexed LV mass demonstrated the strongest association with major adverse cardiovascular events (hazard ratio 0.89, chi-square 26, p <0.001). In conclusion, myocardial scar by late gadolinium enhancement-CMR is infrequent in patients with anthracycline-cardiomyopathy despite a reduced ejection fraction, the event rate in patients with established anthracycline-cardiotoxicity is high, and indexed LV mass by CMR imaging is a predictor of adverse cardiovascular events.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22917553</pmid><doi>10.1016/j.amjcard.2012.07.040</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anthracyclines - adverse effects Anthracyclines - therapeutic use Biological and medical sciences Biomarkers Cardiology. Vascular system Cardiomyopathies - chemically induced Cardiomyopathies - diagnosis Cardiomyopathies - physiopathology Cardiovascular Cardiovascular disease Chemotherapy Confidence intervals Coronary vessels Female Heart Heart attacks Heart Ventricles - pathology Humans Magnetic Resonance Imaging, Cine - methods Male Medical sciences Methods Mortality Myocarditis. Cardiomyopathies Neoplasms - drug therapy Prognosis Pulmonary arteries Stroke Volume - drug effects Womens health |
| title | Left Ventricular Mass in Patients With a Cardiomyopathy After Treatment With Anthracyclines |
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