Cardiac MRI Depicts Immune Checkpoint Inhibitor-induced Myocarditis: A Prospective Study.

Area of Science:

• Cardiology
• Oncology
• Radiology

Background:

• Immune checkpoint inhibitors (ICIs) are crucial cancer therapies but can cause immune-related adverse events, including myocarditis.
• Subclinical cardiac effects of ICI therapy remain poorly understood, necessitating advanced imaging techniques.

Purpose of the Study:

• To assess cardiac injury and inflammation in cancer patients undergoing ICI therapy using cardiac MRI.
• To detect subclinical cardiac changes associated with ICI treatment.

Main Methods:

• Prospective study of 22 cancer patients without pre-existing heart conditions, undergoing cardiac MRI at baseline and 3 months post-ICI initiation.
• Multiparametric cardiac MRI assessed function, myocardial edema (T1/T2 relaxation times, T2 signal intensity ratio), late gadolinium enhancement (LGE), and systolic strain.

Main Results:

• Cardiac MRI showed increased myocardial edema markers (T1, T2 relaxation times, T2 signal intensity ratio) and decreased left ventricular systolic longitudinal strain post-ICI therapy.
• New nonischemic LGE lesions were observed in 9% of participants, and pericardial effusions increased significantly (5% to 45%).

Conclusions:

• Cardiac MRI demonstrates subclinical myocardial edema, inflammation, and systolic dysfunction in patients receiving ICI therapy.
• These findings highlight the potential for cardiac injury during ICI treatment, even in asymptomatic individuals.