Circulation: Cardiovascular Imaging HCI Longitudinal Assessment of Concurrent Changes in Left Ventricular Ejection Fraction and Left Ventricular Myocardial Tissue Characteristics After Administration of Cardiotoxic Chemotherapies Using T1-Weighted and T2-Weighted Cardiovascular Magnetic Resonance Jordan et al: Qualitative CMR Changes after Chemotherapy CIRCCVIM/2014/002217 CIRCCVIM/2014/002217 10.1161/CIRCIMAGING.114.002217 7 11/18/14 6 Picillo Emily 617-542-5100 617-542-6539 Raman, Subha Ohio State University Dr. W. Gregory Hundley ghundley@wakehealth.edu Dr. Wake Forest University School of Medicine 1 Medical Center Boulevard Winston-Salem North Carolina 27157-1045 UNITED STATES 336-716-6125 336-716-9188 7336 Jennifer Hawthorne Jordan Wake Forest School of Medicine jenjorda@wakehealth.edu 167346 Ralph D'Agostino Jr. Wake Forest University Baptist Medical Center rdagosti@wfubmc.edu 64724 Craig Hamilton Wake Forest School of Medicine crhamilt@wakehealth.edu 105089 Sujethra Vasu Wake Forest School of Medicine svasu@wakehealth.edu 105087 Michael E. Hall University of Mississippi Medical Center mehall@umc.edu 24213 Dalane Kitzman Wake Forest School of MNedicine dkitzman@wakehealth.edu 186731 Vinay Thohan Aurora Health Vinay.Thohan@aurora.org 151486 Julia Lawrence Wake Forest School of Medicine jalawren@wakehealth.edu 167368 Leslie Renee Ellis Wake Forest School of Medicine lrellis@wakehealth.edu 167369 Timothy L. Lash Emory University timothy.lee.lash@emory.edu 167227 W. Gregory Hundley Wake Forest University School of Medicine ghundley@wakehealth.edu 7336 05/19/2014 05/19/2014 09/23/2014 09/30/2014 10/01/2014 11/18/2014 Original Articles T1-weighted imaging T2-weighted imaging <p><b><i>Background</i></b>—In a murine anthracycline-related cardiotoxicity model, increases in cardiovascular magnetic resonance (CMR) myocardial contrast-enhanced T1-weighted signal intensity are associated with myocellular injury and decreases in left ventricular ejection fraction (LVEF). We sought to determine if T1- and T2-weighted measures of signal intensity associate with decreases in LVEF in human subjects receiving potentially cardiotoxic chemotherapy. </p><p><b><i>Methods and Results</i></b>—In 65 individuals with breast cancer (n=51) or a hematologic malignancy (n=14), we measured left ventricular volumes, EF, and contrast-enhanced T1-weighted and T2-weighted signal intensity prior to and 3 months after initiating potentially cardiotoxic chemotherapy using blinded, unpaired analysis of CMR images. Participants were aged 51±12 years of whom 55% received an anthracycline, 38% received a monoclonal antibody, and 6% received an antimicrotubule agent. Overall, LVEF decreased from 57±6% to 54±7% (p<0.001) due to an increase in end-systolic volume (p<0.05). T1-weighted signal intensities also increased from 14.1±5.1 to 15.9±6.8 (p<0.05) with baseline values trending higher among individuals who received chemotherapy prior to study enrollment (p=0.06). Changes in T1-weighted signal intensity did not differ within the 17 LV myocardial segments (p=0.97). Myocardial edema quantified from T2-weighted images did not change significantly after 3 months (p=0.70). </p><p><b><i>Conclusions</i></b>—Concordant with previous animal studies, CMR measures of contrast-enhanced T1-weighted signal intensity occur commensurate with small but significant LVEF declines 3 months after receipt of potentially cardiotoxic chemotherapy. These data indicate that changes in T1-weighted signal intensity may serve as an early marker of subclinical injury related to the administration of potentially cardiotoxic chemotherapy in human subjects.</p> 2 0 0 3 3 no yes CIRCCVIM_CIRCCVIM-2014-002217.xml Jordan - Qualitative CMR changes after Chemotherapy - Clinical Perspective Summary.docx

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CIRCCVIM_CIRCCVIM-2014-002217_supp2.pdf CIRCCVIM_CIRCCVIM-2014-002217_file1.docx CIRCCVIM_CIRCCVIM-2014-002217_merge.pdf CIRCCVIM_CIRCCVIM-2014-002217_Kitzman_186731_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Kitzman_186731_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Thohan_151486_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Thohan_151486_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Hamilton_105089_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Hamilton_105089_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Ellis_167369_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Ellis_167369_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Hundley_7336_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Hundley_7336_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Hall_24213_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Hall_24213_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Jordan_167346_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Jordan_167346_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Lash_167227_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Lash_167227_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Lawrence_167368_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Lawrence_167368_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_Vasu_105087_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_Vasu_105087_copyright.pdf CIRCCVIM_CIRCCVIM-2014-002217_DAgostino_Jr_64724_disclosure.pdf CIRCCVIM_CIRCCVIM-2014-002217_DAgostino_Jr_64724_copyright.pdf Please charge authors $70 per page MS has clinical perspective and supplemental PDF Please set the flag 'exportcadmusahafundingtypecodes' with the funding type code of the sources you wish to list. Subject Codes: [30] CT and MRI epicillo