Cardiac MRI: a Translational Imaging Tool for Characterizing Anthracycline-Induced Myocardial Remodeling.
Cardiovascular side effects of cancer therapeutics are the leading causes of morbidity and mortality in cancer survivors. Anthracyclines (AC) serve as the backbone of many anti-cancer treatment strategies, but dose-dependent myocardial injury limits their use. Cumulative AC exposure can disrupt the dynamic equilibrium of the myocardial microarchitecture while repeated injury and repair leads to myocyte loss, interstitial myocardial fibrosis, and impaired contractility. Although children are assumed to have greater myocardial plasticity, AC exposure at a younger age portends worse prognosis. In older patients, there is lower overall survival once they develop cardiovascular disease. Because aberrations in the myocardial architecture predispose the heart to a decline in function, early detection with sensitive imaging tools is crucial and the implications for resource utilization are substantial. As a comprehensive imaging modality, cardiac magnetic resonance (CMR) imaging is able to go beyond quantification of ejection fraction and myocardial deformation to characterize adaptive microstructural and microvascular changes that are important to myocardial tissue health. Herein, we describe CMR as an established translational imaging tool that can be used clinically to characterize AC-associated myocardial remodeling.
Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. klnguyen@ucla.edu.|Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90024, USA. klnguyen@ucla.edu.
Kim-Lien
KL
Nguyen
Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Peng
P
Hu
Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Daniel B
DB
Ennis
Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Jiaxin
J
Shao
Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90024, USA.
Kimberly A
KA
Pham
Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90024, USA.
Joseph J
JJ
Chen
D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009369:Neoplasms / Q000188:drug therapy*; D020257:Ventricular Remodeling
D018943:Anthracyclines
Anthracyclines; Cardiac magnetic resonance imaging; Cardio-oncology; Cardiotoxicity; Translational imaging