Published in:
17-05-2022 | Cytostatic Therapy | Cardiac
Myocardial microvascular function assessed by CMR first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies
Authors:
Meng-Xi Yang, Qing-Li Li, Dan-Qing Wang, Lu Ye, Ke-Min Li, Xiao-Juan Lin, Xue-Sheng Li, Chuan Fu, Xin-Mao Ma, Ying-Kun Guo, Ru-Tie Yin, Zhi-Gang Yang
Published in:
European Radiology
|
Issue 10/2022
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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.