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Updated: Dec 31, 2025
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Delivery of Cardioactive Therapeutics in a Porcine Myocardial Infarction Model
Published on: February 10, 2023
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Myocardial Injury Following Immune Checkpoint Inhibitors: An Australian Experience
Briella K Egberts1, Rajiv Ananthakrishna2, Rebecca Perry3
1College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, SA, Australia; South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
Heart, Lung & Circulation
|April 9, 2025
Summary
Immune checkpoint inhibitors (ICIs) may cause subclinical myocardial injury, detected by advanced cardiac imaging, despite low troponin increases. Further research is crucial to understand ICI cardiotoxicity.
Area of Science:
- Cardiology
- Oncology
- Immunology
Background:
- Immune checkpoint inhibitors (ICIs) are vital cancer therapies.
- Concerns exist regarding ICI-induced cardiotoxicity, specifically subclinical myocardial injury.
- Limited local data exists on the incidence of ICI-related cardiac complications.
Purpose of the Study:
- To assess subclinical myocardial injury in patients receiving ICI therapy without pre-existing cardiovascular disease.
- Utilize biochemical markers and advanced cardiac imaging to detect myocardial injury.
- Evaluate the incidence of cardiac complications in this patient population.
Main Methods:
- Prospective pilot study of 41 patients on ICI therapy.
- Serial assessments included cardiac troponin I (cTnI), NT-proBNP, echocardiography with strain analysis, and cardiac MRI (CMR) at 6 weeks.
- A control group (n=10) was included for comparison.
Main Results:
- Low incidence (2.7%) of significant cTnI increase observed.
- Significant decrease in left ventricular global longitudinal strain (LV-GLS) in the ICI group.
- CMR revealed abnormalities in 55% of patients, with 45% showing increased T1 mapping correlating with reduced LV-GLS.
- Major adverse cardiac events occurred in 45.9% of patients within 1 year.
Conclusions:
- Subclinical myocardial injury is detectable via advanced cardiac imaging post-ICI initiation, despite low troponin elevation.
- The findings highlight the need for larger studies to investigate ICI cardiotoxicity prevalence, mechanisms, and clinical impact.
Keywords:
Cardiovascular magnetic resonanceEchocardiographyImmune checkpoint inhibitorsMyocardial injuryTroponin IMore Related Videos
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