Cardiac MRI assessment of anthracycline-induced cardiotoxicity

Leila Mabudian; Jennifer H Jordan; Wendy Bottinor; W Gregory Hundley

doi:10.3389/fcvm.2022.903719

Cardiac MRI assessment of anthracycline-induced cardiotoxicity

Front Cardiovasc Med. 2022 Sep 27:9:903719. doi: 10.3389/fcvm.2022.903719. eCollection 2022.

Authors

Leila Mabudian¹, Jennifer H Jordan^{1

2}, Wendy Bottinor¹, W Gregory Hundley¹

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, VCU School of Medicine, Richmond, VA, United States.
² Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States.

Abstract

The objective of this review article is to discuss how cardiovascular magnetic resonance (CMR) imaging measures left ventricular (LV) function, characterizes tissue, and identifies myocardial fibrosis in patients receiving anthracycline-based chemotherapy (Anth-bC). Specifically, CMR can measure LV ejection fraction (EF), volumes at end-diastole (LVEDV), and end-systole (LVESV), LV strain, and LV mass. Tissue characterization is accomplished through T1/T2-mapping, late gadolinium enhancement (LGE), and CMR perfusion imaging. Despite CMR's accuracy and efficiency in collecting data about the myocardium, there are challenges that persist while monitoring a cardio-oncology patient undergoing Anth-bC, such as the presence of other cardiovascular risk factors and utility controversies. Furthermore, CMR can be a useful adjunct during cardiopulmonary exercise testing to pinpoint cardiovascular mediated exercise limitations, as well as to assess myocardial microcirculatory damage in patients undergoing Anth-bC.

Keywords: anthracycline; cancer treatment; cardiac MRI; cardiac assessment; cardiotoxicity.

Publication types

Review