Myocardial T1 and T2 Mapping by Magnetic Resonance in Patients With Immune Checkpoint Inhibitor-Associated Myocarditis.
BACKGROUND: Myocarditis is a potentially fatal complication of immune checkpoint inhibitor (ICI) therapy. Data on the utility of cardiovascular magnetic resonance (CMR) T1 and T2 mapping in ICI myocarditis are limited.
OBJECTIVES: This study sought to assess the value of CMR T1 and T2 mapping in patients with ICI myocarditis.
METHODS: In this retrospective study from an international registry of patients with ICI myocarditis, clinical and CMR findings (including T1 and T2 maps) were collected. Abnormal T1 and T2 were defined as 2 SD above site (vendor/field strength specific) reference values and a z-score was calculated for each patient. Major adverse cardiovascular events (MACE) were a composite of cardiovascular death, cardiogenic shock, cardiac arrest, and complete heart block.
RESULTS: Of 136 patients with ICI myocarditis with a CMR, 86 (63%) had T1 maps and 79 (58%) also had T2 maps. Among the 86 patients (66.3 ± 13.1 years of age), 36 (41.9%) had a left ventricular ejection fraction
CONCLUSIONS: The use of T1 mapping and application of the modified Lake Louise Criteria provides important diagnostic value, and T1 mapping provides prognostic value in patients with ICI myocarditis.
Published In/Presented At
Thavendiranathan, P., Zhang, L., Zafar, A., Drobni, Z. D., Mahmood, S. S., Cabral, M., Awadalla, M., Nohria, A., Zlotoff, D. A., Thuny, F., Heinzerling, L. M., Barac, A., Sullivan, R. J., Chen, C. L., Gupta, D., Kirchberger, M. C., Hartmann, S. E., Weinsaft, J. W., Gilman, H. K., Rizvi, M. A., … Neilan, T. G. (2021). Myocardial T1 and T2 Mapping by Magnetic Resonance in Patients With Immune Checkpoint Inhibitor-Associated Myocarditis. Journal of the American College of Cardiology, 77(12), 1503–1516. https://doi.org/10.1016/j.jacc.2021.01.050
Medicine and Health Sciences
Department of Medicine