Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy

Abstract There are limited data on the effects of anthracyclines on right ventricular (RV) structure, function, and tissue characteristics. The goal of this study was to investigate the effects of anthracyclines on the RV using cardiac magnetic resonance (CMR). This was a post-hoc analysis of a pros...

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Autores principales:	Thiago Ferreira de Souza, Thiago Quinaglia Silva, Lígia Antunes-Correa, Zsofia D. Drobni, Felipe Osório Costa, Sergio San Juan Dertkigil, Wilson Nadruz, Fabrício Brenelli, Andrei C. Sposito, José Roberto Matos-Souza, Otávio Rizzi Coelho, Tomas G. Neilan, Michael Jerosch-Herold, Otávio Rizzi Coelho-Filho
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/86f331c601744a65ba8265c0d625b14e
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spelling	oai:doaj.org-article:86f331c601744a65ba8265c0d625b14e2021-12-02T16:35:05ZCardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy10.1038/s41598-021-96630-y2045-2322https://doaj.org/article/86f331c601744a65ba8265c0d625b14e2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96630-yhttps://doaj.org/toc/2045-2322Abstract There are limited data on the effects of anthracyclines on right ventricular (RV) structure, function, and tissue characteristics. The goal of this study was to investigate the effects of anthracyclines on the RV using cardiac magnetic resonance (CMR). This was a post-hoc analysis of a prospective study of 27 breast cancer (BC) patients (51.8 ± 8.9 years) using CMR prior, and up to 3-times after anthracyclines (240 mg/m2) to measure RV volumes and mass, RV extracellular volume (ECV) and cardiomyocyte mass (CM). Before anthracyclines, LVEF (69.4 ± 3.6%) and RVEF (55.6 ± 9%) were normal. The median follow-up after anthracyclines was 399 days (IQR 310–517). The RVEF reached its nadir (46.3 ± 6.8%) after 9-months (P < 0.001). RV mass-index and RV CM decreased to 13 ± 2.8 g/m2 and 8.13 ± 2 g/m2, respectively, at 16-months after anthracyclines. The RV ECV expanded from 0.26 ± 0.07 by 0.14 (53%) to 0.40 ± 0.1 (P < 0.001). The RV ECV expansion correlated with a decrease in RV mass-index (r = −0.46; P < 0.001) and the increase in CK-MB. An RV ESV index at baseline above its median predicted an increased risk of LV dysfunction post-anthracyclines. In BC patients treated with anthracyclines, RV atrophy, systolic dysfunction, and a parallel increase of diffuse interstitial fibrosis indicate a cardiotoxic response on a similar scale as previously seen in the systemic left ventricle.Thiago Ferreira de SouzaThiago Quinaglia SilvaLígia Antunes-CorreaZsofia D. DrobniFelipe Osório CostaSergio San Juan DertkigilWilson NadruzFabrício BrenelliAndrei C. SpositoJosé Roberto Matos-SouzaOtávio Rizzi CoelhoTomas G. NeilanMichael Jerosch-HeroldOtávio Rizzi Coelho-FilhoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thiago Ferreira de Souza Thiago Quinaglia Silva Lígia Antunes-Correa Zsofia D. Drobni Felipe Osório Costa Sergio San Juan Dertkigil Wilson Nadruz Fabrício Brenelli Andrei C. Sposito José Roberto Matos-Souza Otávio Rizzi Coelho Tomas G. Neilan Michael Jerosch-Herold Otávio Rizzi Coelho-Filho Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
description	Abstract There are limited data on the effects of anthracyclines on right ventricular (RV) structure, function, and tissue characteristics. The goal of this study was to investigate the effects of anthracyclines on the RV using cardiac magnetic resonance (CMR). This was a post-hoc analysis of a prospective study of 27 breast cancer (BC) patients (51.8 ± 8.9 years) using CMR prior, and up to 3-times after anthracyclines (240 mg/m2) to measure RV volumes and mass, RV extracellular volume (ECV) and cardiomyocyte mass (CM). Before anthracyclines, LVEF (69.4 ± 3.6%) and RVEF (55.6 ± 9%) were normal. The median follow-up after anthracyclines was 399 days (IQR 310–517). The RVEF reached its nadir (46.3 ± 6.8%) after 9-months (P < 0.001). RV mass-index and RV CM decreased to 13 ± 2.8 g/m2 and 8.13 ± 2 g/m2, respectively, at 16-months after anthracyclines. The RV ECV expanded from 0.26 ± 0.07 by 0.14 (53%) to 0.40 ± 0.1 (P < 0.001). The RV ECV expansion correlated with a decrease in RV mass-index (r = −0.46; P < 0.001) and the increase in CK-MB. An RV ESV index at baseline above its median predicted an increased risk of LV dysfunction post-anthracyclines. In BC patients treated with anthracyclines, RV atrophy, systolic dysfunction, and a parallel increase of diffuse interstitial fibrosis indicate a cardiotoxic response on a similar scale as previously seen in the systemic left ventricle.
format	article
author	Thiago Ferreira de Souza Thiago Quinaglia Silva Lígia Antunes-Correa Zsofia D. Drobni Felipe Osório Costa Sergio San Juan Dertkigil Wilson Nadruz Fabrício Brenelli Andrei C. Sposito José Roberto Matos-Souza Otávio Rizzi Coelho Tomas G. Neilan Michael Jerosch-Herold Otávio Rizzi Coelho-Filho
author_facet	Thiago Ferreira de Souza Thiago Quinaglia Silva Lígia Antunes-Correa Zsofia D. Drobni Felipe Osório Costa Sergio San Juan Dertkigil Wilson Nadruz Fabrício Brenelli Andrei C. Sposito José Roberto Matos-Souza Otávio Rizzi Coelho Tomas G. Neilan Michael Jerosch-Herold Otávio Rizzi Coelho-Filho
author_sort	Thiago Ferreira de Souza
title	Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
title_short	Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
title_full	Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
title_fullStr	Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
title_full_unstemmed	Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
title_sort	cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/86f331c601744a65ba8265c0d625b14e
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Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy

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