Cardiac Magnetic Resonance-Based Layer-Specific Strain in Immune Checkpoint Inhibitor-Associated Myocarditis

作者：Zheng Li, Rui Zhao, Cong Wang, Yan Wang, Jinyi Lin, Shihai Zhao, Jiahui Chen, Yuhong Zhou, Tianshu Liu, Feng Wang, Xianhong Shu, Meng-Su Zeng, Leilei Cheng · 发表于：ESC Heart Failure · 年份：2024 · DOI：10.1002/ehf2.14664 · 被引用次数：11 · 研究领域：Cancer Immunotherapy and Biomarkers、Chemotherapy-induced cardiotoxicity and mitigation、Cardiac Imaging and Diagnostics

AIMS: To assess the different imaging characteristics between corticosteroid-sensitive (CS) and corticosteroid-refractory (CR) immune checkpoint inhibitor-associated myocarditis (ICIaM) with cardiac magnetic resonance (CMR) and the potential CMR parameters in the early detection of CR ICIaM. METHODS AND RESULTS: Thirty-five patients diagnosed with ICIaM and 30 age and gender-matched cancer patients without a history of ICI treatment were enrolled. CMR with contrast was performed within 2 days of clinical suspicion. Left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) were assessed by CMR. LV sub-endocardial (GLSendo) and sub-epicardial (GLSepi) global longitudinal strains were quantified by offline feature tracking analysis. CS and CR ICIaM were defined based on the trend of Troponin I and clinical course during corticosteroid treatment. All 35 patients presented with non-fulminant symptoms upon initial assessment. Twenty patients (57.14%) were sensitive, and 15 (42.86%) were refractory to corticosteroids. Compared with controls, 22 patients (62.86%) with ICIaM developed LGE. LVEF decreased in CR ICIaM compared with the CS group and controls. GLSendo (-14.61 ± 2.67 vs. -18.50 ± 2.53, P < 0.001) and GLSepi (-14.75 ± 2.53 vs. -16.68 ± 2.05, P < 0.001) significantly increased in patients with CR ICIaM compared with the CS ICIaM. In patients with CS ICIaM, although GLSepi (-16.68 ± 2.05 vs. -19.31 ± 1.80, P < 0.001) was impaired compared with the contro...