학술논문
Cardiac magnetic resonance‐based layer‐specific strain in immune checkpoint inhibitor‐associated myocarditis
Document Type
article
Author
Source
ESC Heart Failure, Vol 11, Iss 2, Pp 1061-1075 (2024)
Subject
Language
English
ISSN
2055-5822
Abstract
Abstract 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