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  • Oral presentation
  • Open Access

Left ventricular mass by cardiac magnetic resonance imaging and adverse cardiovascular outcomes in patients treated with anthracycline-based chemotherapy

  • 1, 2,
  • 2,
  • 2,
  • 3,
  • 2 and
  • 2
Journal of Cardiovascular Magnetic Resonance201214 (Suppl 1) :O30

https://doi.org/10.1186/1532-429X-14-S1-O30

  • Published:

Keywords

  • Cardiomyopathy
  • Powerful Predictor
  • Adverse Outcome
  • Cardiac Magnetic Resonance
  • Late Gadolinium Enhancement

Summary

LV mass by CMR is a powerful predictor of adverse cardiovascular outcomes in patients treated with anthracyclines.

Background

Late gadolinium enhancement (LGE) is a predictor of adverse outcomes in patients. However, limited data exist on the role of LGE, the characteristic CMR findings, and the prognostic variables in patients who develop a cardiomyopathy after treatment with anthracyclines.

Methods

LGE-CMR imaging was performed in patients with stage B and C heart failure after anthracycline-based chemotherapy. We assessed the association between CMR, EKG, echocardiographic, serum, and clinical variables with adverse outcomes (cardiovascular death and admission for heart failure).

Results

We performed a clinically-indicated CMR study on 50 patients (52% male, mean age of 49 ± 16 years, anthracycline dose of 286 ± 89 mg/m2, and ejection fraction of 38 ± 9%) with AC-mediated cardiomyopathy. Patients presented a median of 45 months after chemotherapy and were followed for a median period of 28 months. LGE was an uncommon finding (3 patients, 6%). There was a strong inverse association between anthracycline dose and indexed left ventricular mass by CMR (r = -.75, p < 0.001, Figure 1). In univariate analysis, indexed LV-mass by CMR demonstrated the strongest unadjusted association with adverse events (hazard ratio: 0.75, chi-squared 26.2, p < 0.001). In a multivariable model, indexed LV-mass demonstrated the strongest association with the primary outcome (Figure 2).

Figure 1

Figure 2

Conclusions

Residual LV-mass measured by CMR is a powerful predictor of subsequent adverse cardiovascular events in patients with anthracycline-induced cardiotoxicity.

Funding

Dr. Neilan is supported by an NIH T32 Training Grant (T32HL09430101A1).

Authors’ Affiliations

(1)
Medicine, Massachusetts General Hospital, Boston, MA, USA
(2)
Medicine, Brigham and Women's Hospital, Boston, MA, USA
(3)
Radiology, Brigham and Women's Hospital, Boston, MA, USA

Copyright

© Neilan et al; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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