MedStar Authors catalog › Details for: Cardiovascular magnetic resonance in immune checkpoint inhibitor-associated myocarditis.
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Cardiovascular magnetic resonance in immune checkpoint inhibitor-associated myocarditis.

by Barac, Ana; Forrestal, Brian J.
Citation: European Heart Journal. 41(18):1733-1743, 2020 May 07..Journal: European heart journal.Published: ; 2020ISSN: 0195-668X.Full author list: Zhang L; Awadalla M; Mahmood SS; Nohria A; Hassan MZO; Thuny F; Zlotoff DA; Murphy SP; Stone JR; Golden DLA; Alvi RM; Rokicki A; Jones-O'Connor M; Cohen JV; Heinzerling LM; Mulligan C; Armanious M; Barac A; Forrestal BJ; Sullivan RJ; Kwong RY; Yang EH; Damrongwatanasuk R; Chen CL; Gupta D; Kirchberger MC; Moslehi JJ; Coelho-Filho OR; Ganatra S; Rizvi MA; Sahni G; Tocchetti CG; Mercurio V; Mahmoudi M; Lawrence DP; Reynolds KL; Weinsaft JW; Baksi AJ; Ederhy S; Groarke JD; Lyon AR; Fradley MG; Thavendiranathan P; Neilan TG.UI/PMID: 32112560.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1093/eurheartj/ehaa051 (Click here) Abbreviated citation: Eur Heart J. 41(18):1733-1743, 2020 May 07.Local Holdings: Available online from MWHC library: 1996 - present (after 1 year), Available in print through MWHC library: 1999 - 2006.Abstract: AIMS: Myocarditis is a potentially fatal complication of immune checkpoint inhibitors (ICI). Sparse data exist on the use of cardiovascular magnetic resonance (CMR) in ICI-associated myocarditis. In this study, the CMR characteristics and the association between CMR features and cardiovascular events among patients with ICI-associated myocarditis are presented.Abstract: METHODS AND RESULTS: From an international registry of patients with ICI-associated myocarditis, clinical, CMR, and histopathological findings were collected. Major adverse cardiovascular events (MACE) were a composite of cardiovascular death, cardiogenic shock, cardiac arrest, and complete heart block. In 103 patients diagnosed with ICI-associated myocarditis who had a CMR, the mean left ventricular ejection fraction (LVEF) was 50%, and 61% of patients had an LVEF >=50%. Late gadolinium enhancement (LGE) was present in 48% overall, 55% of the reduced EF, and 43% of the preserved EF cohort. Elevated T2-weighted short tau inversion recovery (STIR) was present in 28% overall, 30% of the reduced EF, and 26% of the preserved EF cohort. The presence of LGE increased from 21.6%, when CMR was performed within 4 days of admission to 72.0% when CMR was performed on Day 4 of admission or later. Fifty-six patients had cardiac pathology. Late gadolinium enhancement was present in 35% of patients with pathological fibrosis and elevated T2-weighted STIR signal was present in 26% with a lymphocytic infiltration. Forty-one patients (40%) had MACE over a follow-up time of 5 months. The presence of LGE, LGE pattern, or elevated T2-weighted STIR were not associated with MACE.Abstract: CONCLUSION: These data suggest caution in reliance on LGE or a qualitative T2-STIR-only approach for the exclusion of ICI-associated myocarditis. Copyright Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2020. For permissions, please email: [email protected]

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