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Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review

Immune checkpoint inhibitors (ICIs) are a family of anticancer drugs in which the immune response elicited against the tumor may involve other organs, including the heart. Cardiac magnetic resonance (CMR) imaging is increasingly used in the diagnostic work-up of myocardial inflammation; recently, se...

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Autores principales: Arcari, Luca, Tini, Giacomo, Camastra, Giovanni, Ciolina, Federica, De Santis, Domenico, Russo, Domitilla, Caruso, Damiano, Danti, Massimiliano, Cacciotti, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9027245/
https://www.ncbi.nlm.nih.gov/pubmed/35448226
http://dx.doi.org/10.3390/jimaging8040099
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author Arcari, Luca
Tini, Giacomo
Camastra, Giovanni
Ciolina, Federica
De Santis, Domenico
Russo, Domitilla
Caruso, Damiano
Danti, Massimiliano
Cacciotti, Luca
author_facet Arcari, Luca
Tini, Giacomo
Camastra, Giovanni
Ciolina, Federica
De Santis, Domenico
Russo, Domitilla
Caruso, Damiano
Danti, Massimiliano
Cacciotti, Luca
author_sort Arcari, Luca
collection PubMed
description Immune checkpoint inhibitors (ICIs) are a family of anticancer drugs in which the immune response elicited against the tumor may involve other organs, including the heart. Cardiac magnetic resonance (CMR) imaging is increasingly used in the diagnostic work-up of myocardial inflammation; recently, several studies investigated the use of CMR in patients with ICI-myocarditis (ICI-M). The aim of the present systematic review is to summarize the available evidence on CMR findings in ICI-M. We searched electronic databases for relevant publications; after screening, six studies were selected, including 166 patients from five cohorts, and further 86 patients from a sub-analysis that were targeted for a tissue mapping assessment. CMR revealed mostly preserved left ventricular ejection fraction; edema prevalence ranged from 9% to 60%; late gadolinium enhancement (LGE) prevalence ranged from 23% to 83%. T1 and T2 mapping assessment were performed in 108 and 104 patients, respectively. When available, the comparison of CMR with endomyocardial biopsy revealed partial agreement between techniques and was higher for native T1 mapping amongst imaging biomarkers. The prognostic assessment was inconsistently assessed; CMR variables independently associated with the outcome included decreasing LVEF and increasing native T1. In conclusion, CMR findings in ICI-M include myocardial dysfunction, edema and fibrosis, though less evident than in more classic forms of myocarditis; native T1 mapping retained the higher concordance with EMB and significant prognostic value.
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spelling pubmed-90272452022-04-23 Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review Arcari, Luca Tini, Giacomo Camastra, Giovanni Ciolina, Federica De Santis, Domenico Russo, Domitilla Caruso, Damiano Danti, Massimiliano Cacciotti, Luca J Imaging Review Immune checkpoint inhibitors (ICIs) are a family of anticancer drugs in which the immune response elicited against the tumor may involve other organs, including the heart. Cardiac magnetic resonance (CMR) imaging is increasingly used in the diagnostic work-up of myocardial inflammation; recently, several studies investigated the use of CMR in patients with ICI-myocarditis (ICI-M). The aim of the present systematic review is to summarize the available evidence on CMR findings in ICI-M. We searched electronic databases for relevant publications; after screening, six studies were selected, including 166 patients from five cohorts, and further 86 patients from a sub-analysis that were targeted for a tissue mapping assessment. CMR revealed mostly preserved left ventricular ejection fraction; edema prevalence ranged from 9% to 60%; late gadolinium enhancement (LGE) prevalence ranged from 23% to 83%. T1 and T2 mapping assessment were performed in 108 and 104 patients, respectively. When available, the comparison of CMR with endomyocardial biopsy revealed partial agreement between techniques and was higher for native T1 mapping amongst imaging biomarkers. The prognostic assessment was inconsistently assessed; CMR variables independently associated with the outcome included decreasing LVEF and increasing native T1. In conclusion, CMR findings in ICI-M include myocardial dysfunction, edema and fibrosis, though less evident than in more classic forms of myocarditis; native T1 mapping retained the higher concordance with EMB and significant prognostic value. MDPI 2022-04-05 /pmc/articles/PMC9027245/ /pubmed/35448226 http://dx.doi.org/10.3390/jimaging8040099 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Arcari, Luca
Tini, Giacomo
Camastra, Giovanni
Ciolina, Federica
De Santis, Domenico
Russo, Domitilla
Caruso, Damiano
Danti, Massimiliano
Cacciotti, Luca
Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review
title Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review
title_full Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review
title_fullStr Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review
title_full_unstemmed Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review
title_short Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review
title_sort cardiac magnetic resonance imaging in immune check-point inhibitor myocarditis: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9027245/
https://www.ncbi.nlm.nih.gov/pubmed/35448226
http://dx.doi.org/10.3390/jimaging8040099
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