Jialian Li, Yanwei Li, Li Tao, Chuan Zhang, Zhong Zuo
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The analysis revealed that following ICI treatment, the left ventricular global longitudinal strain (GLS) increased significantly [weighted mean difference (WMD) 2.33; 95% confidence interval (CI) 1.26, 3.41; <i>p</i> < 0.01], while the global radial strain (GRS) decreased [WMD -4.73; 95% CI -6.74, -2.71; <i>p</i> < 0.01]. Additionally, T1 and T2 values increased [standardized mean difference (SMD) 1.14; 95% CI 0.59, 1.68; <i>p</i> < 0.01] and [SMD 1.11; 95% CI 0.64, 1.58; <i>p</i> < 0.01], respectively. An elevated T2 was associated with a higher occurrence of major adverse cardiovascular events (MACE), with a hazard ratio of 1.36 (95% CI 1.12, 1.64).</p><p><strong>Conclusions: </strong>Our findings demonstrate that T1, T2, and GLS increase, while GRS decreases following ICI administration. 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引用次数: 0
摘要
背景：心脏磁共振（CMR）的复杂过程和各参数在心脏毒性诊断和预后中的不确定性限制了其在免疫检查点抑制剂（ICI）治疗患者心脏评估中的推广。方法：综合检索PubMed、Web of Science、Embase、中国知网（CNKI）和Cochrane数据库，检索截止到2024年9月28日发表的相关文章。结果：经筛选，8篇文章纳入本研究。分析显示，ICI治疗后左室总纵向应变（GLS）显著升高[加权平均差（WMD） 2.33；95%置信区间（CI） 1.26, 3.41；p < 0.01]，整体径向应变（GRS）降低[WMD -4.73；95% ci -6.74, -2.71；P < 0.01]。此外，T1和T2值增加[标准化平均差（SMD） 1.14；95% ci 0.59, 1.68；p < 0.01]和[SMD 1.11]；95% ci 0.64, 1.58；P < 0.01]。T2升高与主要不良心血管事件（MACE）发生率升高相关，风险比为1.36 （95% CI 1.12, 1.64）。结论：我们的研究结果表明，ICI治疗后T1、T2和GLS升高，而GRS降低。通过整合这些关键指标，我们提出了一个简化的、简化的（非对比）CMR方案，可以在15分钟内完成，从而促进了CMR在心脏肿瘤学中的整合。普洛斯彼罗注册：CRD42023437238， https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437238。
Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis.
Background: The complex process of cardiac magnetic resonance (CMR) and the uncertainty of each parameter in the diagnosis and prognosis of cardiotoxicity limit its promotion in the cardiac evaluation of patients treated with immune checkpoint inhibitors (ICI).
Methods: A comprehensive search was conducted across PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Cochrane databases for relevant articles published up until September 28, 2024.
Results: After screening, 8 articles were included in this study. The analysis revealed that following ICI treatment, the left ventricular global longitudinal strain (GLS) increased significantly [weighted mean difference (WMD) 2.33; 95% confidence interval (CI) 1.26, 3.41; p < 0.01], while the global radial strain (GRS) decreased [WMD -4.73; 95% CI -6.74, -2.71; p < 0.01]. Additionally, T1 and T2 values increased [standardized mean difference (SMD) 1.14; 95% CI 0.59, 1.68; p < 0.01] and [SMD 1.11; 95% CI 0.64, 1.58; p < 0.01], respectively. An elevated T2 was associated with a higher occurrence of major adverse cardiovascular events (MACE), with a hazard ratio of 1.36 (95% CI 1.12, 1.64).
Conclusions: Our findings demonstrate that T1, T2, and GLS increase, while GRS decreases following ICI administration. By consolidating these critical metrics, we propose a streamlined, abbreviated (non-contrast) CMR protocol that can be completed within 15 minutes, thereby facilitating the integration of CMR in cardio-oncology.
The prospero registration: CRD42023437238, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437238.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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