Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Cardiovascular Toxicology
Published in: Cardiovascular Toxicology 6/2024

Open Access 03-05-2024 | Anthracycline

Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis

Authors: Amira A. Mohamed, Layla Y. Elmancy, Sara M. Abulola, Sara A. Al-Qattan, Mohamed Izham Mohamed Ibrahim, Zaid H. Maayah

Published in: Cardiovascular Toxicology | Issue 6/2024

Login to get access

Abstract

Anthracycline antibiotic is one of the most effective anti-tumor drugs used to manage certain types of breast cancers, lymphomas, and leukemias. However, anthracyclines induce a dose-dependent cardiotoxicity that may progress to heart failure. Thus, using a sensitive predictor of early cardiac dysfunction in patients treated with anthracyclines can help detect subclinical cardiac dysfunction early and help initiate interventions to protect these patients. Among parameters of myocardial measure, cardiac magnetic resonance (CMR)-measured native myocardial T1 mapping is considered a sensitive and accurate quantitative measure of early subclinical cardiac changes, particularly cardiac inflammation and fibrosis. However, to understand the quality and the validity of the current evidence supporting the use of these measures in patients treated with anthracyclines, we aimed to conduct a systematic review of clinical studies of this measure to detect early myocardial changes in cancer patients treated with anthracyclines. The primary outcome was the level of native T1 mapping. We performed fixed-effects meta-analyses and assessed certainty in effect estimates. Of the 1780 publications reviewed (till 2022), 23 were retrieved, and 9 articles met the inclusion criteria. Our study showed that exposure to anthracycline was associated with a significant elevation of native myocardial T1 mapping from baseline (95% CI 0.1121 to 0.5802; p = 0.0037) as well as compared to healthy control patients (95% CI 0.2925 to 0.7448; p < 0.0001). No significant publication bias was noted on the assessment of the funnel plot and Egger’s test. According to the Q test, there was no significant heterogeneity in the included studies (I2 = 0.0000% versus healthy controls and I2 = 14.0666% versus baseline). Overall, our study suggests that native myocardial T1 mapping is useful for detecting anthracycline-induced cardiotoxicity in patients with cancer.
Appendix
Available only for authorised users
Literature
1.
Davis, H. L., & Davis, T. E. (1979). Daunorubicin and adriamycin in cancer treatment: An analysis of their roles and limitations. Cancer Treatment Reports, 63, 809–815.PubMed
2.
Swain, S. M., Whaley, F. S., & Ewer, M. S. (2003). Congestive heart failure in patients treated with doxorubicin: A retrospective analysis of three trials. Cancer, 97, 2869–2879.CrossRefPubMed
3.
Tan-Chiu, E., Yothers, G., Romond, E., Geyer, C. E., Jr., Ewer, M., Keefe, D., Shannon, R. P., Swain, S. M., Brown, A., Fehrenbacher, L., Vogel, V. G., Seay, T. E., Rastogi, P., Mamounas, E. P., Wolmark, N., & Bryant, J. (2005). Assessment of cardiac dysfunction in a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel, with or without trastuzumab as adjuvant therapy in node-positive, human epidermal growth factor receptor 2-overexpressing breast cancer: NSABP B-31. Journal of Clinical Oncology, 23, 7811–7819.CrossRefPubMed
4.
5.
Jones, L. W., Haykowsky, M. J., Swartz, J. J., Douglas, P. S., & Mackey, J. R. (2007). Early breast cancer therapy and cardiovascular injury. Journal of the American College of Cardiology, 50, 1435–1441.CrossRefPubMed
6.
de Vries, S., Schaapveld, M., Janus, C. P. M., Daniels, L. A., Petersen, E. J., van der Maazen, R. W. M., Zijlstra, J. M., Beijert, M., Nijziel, M. R., Verschueren, K. M. S., Kremer, L. C. M., van Eggermond, A. M., Lugtenburg, P. J., Krol, A. D. G., Roesink, J. M., Plattel, W. J., van Spronsen, D. J., van Imhoff, G. W., de Boer, J. P., … van Leeuwen, F. E. (2021). Long-term cause-specific mortality in Hodgkin lymphoma patients. Journal of the National Cancer Institute, 113, 760–769.CrossRefPubMed
7.
Cardinale, D., Colombo, A., Lamantia, G., Colombo, N., Civelli, M., De Giacomi, G., Rubino, M., Veglia, F., Fiorentini, C., & Cipolla, C. M. (2010). Anthracycline-induced cardiomyopathy: Clinical relevance and response to pharmacologic therapy. Journal of the American College of Cardiology, 55, 213–220.CrossRefPubMed
8.
Cardinale, D., Colombo, A., Bacchiani, G., Tedeschi, I., Meroni, C. A., Veglia, F., Civelli, M., Lamantia, G., Colombo, N., Curigliano, G., Fiorentini, C., & Cipolla, C. M. (2015). Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. Circulation, 131, 1981–1988.CrossRefPubMed
9.
Thavendiranathan, P., Walls, M., Giri, S., Verhaert, D., Rajagopalan, S., Moore, S., Simonetti, O. P., & Raman, S. V. (2012). Improved detection of myocardial involvement in acute inflammatory cardiomyopathies using T2 mapping. Circulation: Cardiovascular Imaging, 5, 102–110.PubMed
10.
Ferreira, V. M., Piechnik, S. K., Dall’Armellina, E., Karamitsos, T. D., Francis, J. M., Choudhury, R. P., Friedrich, M. G., Robson, M. D., & Neubauer, S. (2012). Non-contrast T1-mapping detects acute myocardial edema with high diagnostic accuracy: A comparison to T2-weighted cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance, 14, 42.CrossRefPubMedPubMedCentral
11.
Altaha, M. A., Nolan, M., Marwick, T. H., Somerset, E., Houbois, C., Amir, E., Yip, P., Connelly, K. A., Michalowska, M., Sussman, M. S., Wintersperger, B. J., & Thavendiranathan, P. (2020). Can quantitative CMR tissue characterization adequately identify cardiotoxicity during chemotherapy?: Impact of temporal and observer variability. JACC: Cardiovascular Imaging, 13, 951–962.PubMed
12.
Barbosa, M. F., Fusco, D. R., Gaiolla, R. D., Werys, K., Tanni, S. E., Fernandes, R. A., Ribeiro, S. M., & Szarf, G. (2021). Characterization of subclinical diastolic dysfunction by cardiac magnetic resonance feature-tracking in adult survivors of non-Hodgkin lymphoma treated with anthracyclines. BMC Cardiovascular Disorders, 21, 170.CrossRefPubMedPubMedCentral
13.
Costello, B. T., Roberts, T. J., Howden, E. J., Bigaran, A., Foulkes, S. J., Beaudry, R. I., Janssens, K., Haykowsky, M. J., Antill, Y., Nightingale, S., Loi, S., & La Gerche, A. (2019). Exercise attenuates cardiotoxicity of anthracycline chemotherapy measured by global longitudinal strain. JACC CardioOncol, 1, 298–301.CrossRefPubMedPubMedCentral
14.
Kirkham, A. A., Paterson, D. I., Haykowsky, M. J., Beaudry, R. I., Mackey, J. R., Pituskin, E., Grenier, J. G., & Thompson, R. B. (2021). Aerobic fitness is related to myocardial fibrosis post-anthracycline therapy. Medicine and Science in Sports and Exercise, 53, 267–274.CrossRefPubMed
15.
Harries, I., Berlot, B., Ffrench-Constant, N., Williams, M., Liang, K., De Garate, E., Baritussio, A., Biglino, G., Plana, J. C., & Bucciarelli-Ducci, C. (2021). Cardiovascular magnetic resonance characterisation of anthracycline cardiotoxicity in adults with normal left ventricular ejection fraction. International Journal of Cardiology, 343, 180–186.CrossRefPubMed
16.
Muehlberg, F., Funk, S., Zange, L., von Knobelsdorff-Brenkenhoff, F., Blaszczyk, E., Schulz, A., Ghani, S., Reichardt, A., Reichardt, P., & Schulz-Menger, J. (2018). Native myocardial T1 time can predict development of subsequent anthracycline-induced cardiomyopathy. ESC Heart Fail, 5, 620–629.CrossRefPubMedPubMedCentral
17.
Tahir, E., Azar, M., Shihada, S., Seiffert, K., Goy, Y., Beitzen-Heineke, A., Molwitz, I., Muellerleile, K., Stehning, C., Schon, G., Adam, G., Petersen, C., Muller, V., & Lund, G. K. (2022). Myocardial injury detected by T1 and T2 mapping on CMR predicts subsequent cancer therapy-related cardiac dysfunction in patients with breast cancer treated by epirubicin-based chemotherapy or left-sided RT. European Radiology, 32, 1853–1865.CrossRefPubMed
18.
van der Velde, N., Janus, C. P. M., Bowen, D. J., Hassing, H. C., Kardys, I., van Leeuwen, F. E., So-Osman, C., Nout, R. A., Manintveld, O. C., & Hirsch, A. (2021). Detection of subclinical cardiovascular disease by cardiovascular magnetic resonance in lymphoma survivors. JACC CardioOncol, 3, 695–706.CrossRefPubMedPubMedCentral
19.
Melendez, G. C., Jordan, J. H., D’Agostino, R. B., Jr., Vasu, S., Hamilton, C. A., & Hundley, W. G. (2017). Progressive 3-month increase in LV myocardial ECV after anthracycline-based chemotherapy. JACC: Cardiovascular Imaging, 10, 708–709.PubMed
20.
Jordan, J. H., Vasu, S., Morgan, T. M., D’Agostino, R. B., Jr., Melendez, G. C., Hamilton, C. A., Arai, A. E., Liu, S., Liu, C. Y., Lima, J. A., Bluemke, D. A., Burke, G. L., & Hundley, W. G. (2016). Anthracycline-associated T1 mapping characteristics are elevated independent of the presence of cardiovascular comorbidities in cancer survivors. Circulation: Cardiovascular Imaging, 9, e004325.PubMed
21.
Kirkham, A. A., Pituskin, E., Thompson, R. B., Mackey, J. R., Koshman, S. L., Jassal, D., Pitz, M., Haykowsky, M. J., Pagano, J. J., Chow, K., Tsui, A. K., Ezekowitz, J. A., Oudit, G. Y., & Paterson, D. I. (2022). Cardiac and cardiometabolic phenotyping of trastuzumab-mediated cardiotoxicity: A secondary analysis of the MANTICORE trial. European Heart Journal-Cardiovascular Pharmacotherapy, 8, 130–139.CrossRefPubMed
22.
Badano, L. P., & Muraru, D. (2017). The good, the bad, and the ugly of using left ventricular longitudinal myocardial deformation by speckle-tracking echocardiography to assess patients after an acute myocardial infarction. Circulation: Cardiovascular Imaging, 10, e006693.PubMed
23.
Kocabay, G., Muraru, D., Peluso, D., Cucchini, U., Mihaila, S., Padayattil-Jose, S., Gentian, D., Iliceto, S., Vinereanu, D., & Badano, L. P. (2014). Normal left ventricular mechanics by two-dimensional speckle-tracking echocardiography. Reference values in healthy adults. Revista Española de Cardiología (English Edition), 67, 651–658.CrossRef
24.
Treiber, J., Hausmann, C. S., Wolter, J. S., Fischer-Rasokat, U., Kriechbaum, S. D., Hamm, C. W., Nagel, E., Puntmann, V. O., & Rolf, A. (2023). Native T1 is predictive of cardiovascular death/heart failure events and all-cause mortality irrespective of the patient’s volume status. Frontiers in Cardiovascular Medicine, 10, 1091334.CrossRefPubMedPubMedCentral
25.
Seno, A., Antiochos, P., Lichtenfeld, H., Rickers, E., Qamar, I., Ge, Y., Blankstein, R., Steigner, M., Aghayev, A., Jerosch-Herold, M., & Kwong, R. Y. (2022). Prognostic value of T1 mapping and feature tracking by cardiac magnetic resonance in patients with signs and symptoms suspecting heart failure and no clinical evidence of coronary artery disease. Journal of the American Heart Association, 11, e020981.CrossRefPubMedPubMedCentral
26.
Melendez, G. C., & Hundley, W. G. (2016). Is myocardial fibrosis a new frontier for discovery in cardiotoxicity related to the administration of anthracyclines? Circulation: Cardiovascular Imaging, 9, e005797.PubMed
27.
Maayah, Z. H., Takahara, S., & Dyck, J. R. B. (2021). The beneficial effects of reducing NLRP3 inflammasome activation in the cardiotoxicity and the anti-cancer effects of doxorubicin. Archives of Toxicology, 95, 1–9.CrossRefPubMed
28.
Sun, Z. M., Guan, P., Luo, L. F., Qin, L. Y., Wang, N., Zhao, Y. S., & Ji, E. S. (2020). Resveratrol protects against CIH-induced myocardial injury by targeting Nrf2 and blocking NLRP3 inflammasome activation. Life Sciences, 245, 117362.CrossRefPubMed
29.
Yang, K., Li, W., Duan, W., Jiang, Y., Huang, N., Li, Y., Ren, B., & Sun, J. (2019). Resveratrol attenuates pulmonary embolism associated cardiac injury by suppressing activation of the inflammasome via the MALAT1miR223p signaling pathway. International Journal of Molecular Medicine, 44, 2311–2320.PubMed
30.
Dong, W., Yang, R., Yang, J., Yang, J., Ding, J., Wu, H., & Zhang, J. (2015). Resveratrol pretreatment protects rat hearts from ischemia/reperfusion injury partly via a NALP3 inflammasome pathway. International Journal of Clinical and Experimental Pathology, 8, 8731–8741.PubMedPubMedCentral
31.
Maayah, Z. H., Alam, A. S., Takahara, S., Soni, S., Ferdaoussi, M., Matsumura, N., Zordoky, B. N., Eisenstat, D. D., & Dyck, J. R. B. (2021). Resveratrol reduces cardiac NLRP3-inflammasome activation and systemic inflammation to lessen doxorubicin-induced cardiotoxicity in juvenile mice. FEBS Letters, 595, 1681–1695.CrossRefPubMedPubMedCentral
32.
Maayah, Z. H., Abdelhamid, G., Elshenawy, O. H., El-Sherbeni, A. A., Althurwi, H. N., McGinn, E., Dawood, D., Alammari, A. H., & El-Kadi, A. O. S. (2018). The role of soluble epoxide hydrolase enzyme on daunorubicin-mediated cardiotoxicity. Cardiovascular Toxicology, 18, 268–283.CrossRefPubMed
33.
Quagliariello, V., De Laurentiis, M., Rea, D., Barbieri, A., Monti, M. G., Carbone, A., Paccone, A., Altucci, L., Conte, M., Canale, M. L., Botti, G., & Maurea, N. (2021). The SGLT-2 inhibitor empagliflozin improves myocardial strain, reduces cardiac fibrosis and pro-inflammatory cytokines in non-diabetic mice treated with doxorubicin. Cardiovascular Diabetology, 20, 150.CrossRefPubMedPubMedCentral
34.
Quagliariello, V., Passariello, M., Di Mauro, A., Cipullo, C., Paccone, A., Barbieri, A., Palma, G., Luciano, A., Buccolo, S., Bisceglia, I., Canale, M. L., Gallucci, G., Inno, A., De Lorenzo, C., & Maurea, N. (2022). Immune checkpoint inhibitor therapy increases systemic SDF-1, cardiac DAMPs Fibronectin-EDA, S100/Calgranulin, galectine-3, and NLRP3-MyD88-chemokine pathways. Frontiers in Cardiovascular Medicine, 9, 930797.CrossRefPubMedPubMedCentral
35.
Hu, J., Xu, J., Tan, X., Li, D., Yao, D., Xu, B., & Lei, Y. (2023). Dapagliflozin protects against dilated cardiomyopathy progression by targeting NLRP3 inflammasome activation. Naunyn-Schmiedeberg’s Archives of Pharmacology, 396, 1461–1470.PubMedPubMedCentral
36.
Quagliariello, V., Bisceglia, I., Berretta, M., Iovine, M., Canale, M. L., Maurea, C., Giordano, V., Paccone, A., Inno, A., & Maurea, N. (2023). PCSK9 inhibitors in cancer patients treated with immune-checkpoint inhibitors to reduce cardiovascular events: new frontiers in cardioncology. Cancers (Basel), 15, 1397.CrossRefPubMed
37.
Jellis, C. L., & Kwon, D. H. (2014). Myocardial T1 mapping: Modalities and clinical applications. Cardiovascular Diagnosis and Therapy, 4, 126–137.PubMedPubMedCentral
Metadata
Title
Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis
Authors
Amira A. Mohamed
Layla Y. Elmancy
Sara M. Abulola
Sara A. Al-Qattan
Mohamed Izham Mohamed Ibrahim
Zaid H. Maayah
Publication date
03-05-2024
Publisher
Springer US
Published in
Cardiovascular Toxicology / Issue 6/2024
Print ISSN: 1530-7905
Electronic ISSN: 1559-0259
DOI
https://doi.org/10.1007/s12012-024-09866-1

Other articles of this Issue 6/2024

Cardiovascular Toxicology 6/2024 Go to the issue

Research

USP18 Curbs the Progression of Metabolic Hypertension by Suppressing JAK/STAT Pathway

Research

Betaine Protects Mice from Cardiotoxicity Triggered by Sodium Arsenite Through Antioxidative and Anti-inflammatory Pathways

Research

Role of Early Left Atrial Functional Decline in Predicting Cardiotoxicity in HER2 Positive Breast Cancer Patients Treated With Trastuzumab

Review

SIRT6 in Regulation of Mitochondrial Damage and Associated Cardiac Dysfunctions: A Possible Therapeutic Target for CVDs

Research

Linarin Ameliorates Restenosis After Vascular Injury in Type 2 Diabetes Mellitus via Regulating ADAM10-Mediated Notch Signaling Pathway

Correction

Correction: Uncovering the Mechanism of Chinese Hawthorn Leaf on Myocardial Ischemia Based on Network Pharmacology, Molecular Docking Verification, and In Vitro Studies

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits