Myocardial T1 and T2 Mapping by Magnetic Resonance in Patients With Immune Checkpoint Inhibitor-Associated Myocarditis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Thavendiranathan Paaladinesh, Zhang Lili, Zafar Amna, Drobni Zsofia D, Mahmood Syed S, Cabral Marcella, Awadalla Magid, Nohria Anju, Zlotoff Daniel A, Thuny Franck, Heinzerling Lucie M, Barac Ana, Sullivan Ryan J, Chen Carol L, Gupta Dipti, Kirchberger Michael C, Hartmann Sarah E, Weinsaft Jonathan W, Gilman Hannah K, Rizvi Muhammad A, Kovacina Bojan, Michel Caroline, Sahni Gagan, González-Mansilla Ana, Calles Antonio, Fernández-Avilés Francisco, Mahmoudi Michael, Reynolds Kerry L, Ganatra Sarju, Gavira Juan José, González Nahikari Salterain, García de Yébenes Castro Manuel, Kwong Raymond Y, Jerosch-Herold Michael, Coelho-Filho Otavio R, Afilalo Jonathan, Zataraín-Nicolás Eduardo, Baksi A John, Wintersperger Bernd J, Calvillo-Arguelles Oscar, Ederhy Stephane, Yang Eric H, Lyon Alexander R, Fradley Michael G, Neilan Tomas G
Аннотация
OBJECTIVES: This study sought to assess the value of CMR T1 and T2 mapping in patients with ICI myocarditis.
METHODS: In this retrospective study from an international registry of patients with ICI myocarditis, clinical and CMR findings (including T1 and T2 maps) were collected. Abnormal T1 and T2 were defined as 2 SD above site (vendor/field strength specific) reference values and a z-score was calculated for each patient. Major adverse cardiovascular events (MACE) were a composite of cardiovascular death, cardiogenic shock, cardiac arrest, and complete heart block.
RESULTS: Of 136 patients with ICI myocarditis with a CMR, 86 (63%) had T1 maps and 79 (58%) also had T2 maps. Among the 86 patients (66.3 ± 13.1 years of age), 36 (41.9%) had a left ventricular ejection fraction <55%. Across all patients, mean z-scores for T1 and T2 values were 2.9 ± 1.9 (p < 0.001) and 2.2 ± 2.1 (p < 0.001), respectively. On Siemens 1.5-T scanner (n = 67), native T1 (1,079.0 ± 55.5 ms vs. 1,000.3 ± 22.1 ms; p < 0.001) and T2 (56.2 ± 4.9 ms vs. 49.8 ± 2.2 ms; p < 0.001) values were elevated compared with reference values. Abnormal T1 and T2 values were seen in 78% and 43% of the patients, respectively. Applying the modified Lake Louise Criteria, 95% met the nonischemic myocardial injury criteria and 53% met the myocardial edema criteria. Native T1 values had excellent discriminatory value for subsequent MACE, with an area under the curve of 0.91 (95% confidence interval: 0.84 to 0.98). Native T1 values (for every 1-unit increase in z-score, hazard ratio: 1.44; 95% confidence interval: 1.12 to 1.84; p = 0.004) but not T2 values were independently associated with subsequent MACE.
CONCLUSIONS: The use of T1 mapping and application of the modified Lake Louise Criteria provides important diagnostic value, and T1 mapping provides prognostic value in patients with ICI myocarditis.