Global Circumferential and Radial Strain Among Patients With Immune Checkpoint Inhibitor Myocarditis
Thiago Quinaglia1, Carlos Gongora1, Magid Awadalla1
1Cardiovascular Imaging Research Center (CIRC), Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
JACC. Cardiovascular Imaging
|November 10, 2022
Summary
Global circumferential strain (GCS) and global radial strain (GRS) are significantly reduced in patients with immune checkpoint inhibitor (ICI) myocarditis. Lower GCS and GRS predict major adverse cardiovascular events, offering prognostic value beyond traditional markers.
Area of Science:
- Cardiology
- Oncology
- Immunology
Background:
- Cytotoxic chemotherapy is known to reduce global circumferential strain (GCS) and global radial strain (GRS).
- Limited data exist on the impact of immune checkpoint inhibitor (ICI) myocarditis on GCS and GRS.
Purpose of the Study:
- To elucidate the role of GCS and GRS in the context of ICI myocarditis.
- To assess the prognostic significance of GCS and GRS in patients with ICI myocarditis.
Main Methods:
- Retrospective analysis comparing GCS and GRS in 75 patients with ICI myocarditis and 50 ICI-treated controls without myocarditis.
- Baseline GCS and GRS data were available for a subset of patients.
- Major adverse cardiovascular events (MACEs) were tracked, including cardiogenic shock, cardiac arrest, complete heart block, and cardiac death.
Main Results:
- Patients with ICI myocarditis exhibited significantly lower GCS and GRS compared to controls.
- Reduced GCS and GRS below the median were associated with an increased rate of cardiovascular events.
- GCS and GRS demonstrated superior predictive performance for adverse events compared to cardiac troponin T, LVEF, and age.
Conclusions:
- Global circumferential strain and global radial strain are diminished in ICI myocarditis.
- The degree of reduction in GCS and GRS holds significant prognostic value for cardiovascular events.
- GCS and GRS offer incremental prognostic utility in patients with ICI myocarditis.
Keywords:
cardiovascular risk stratificationimmune checkpoint inhibitorsmyocarditisstrain modalities survival analysisMore Related Videos
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