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Cardiac MRI Myocardial Functional and Tissue Characterization Detects Early Cardiac Dysfunction in a Mouse Model of Chemotherapy‐Induced Cardiotoxicity
Author(s) -
Naresh Nivedita K.,
Misener Sol,
Zhang Zhouli,
Yang Cynthia,
Ruh Alexander,
Bertolino Nicola,
Epstein Frederick H.,
Collins Jeremy D.,
Markl Michael,
Procissi Daniele,
Carr James C.,
Allen Bradley A.
Publication year - 2020
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.4327
Subject(s) - cardiotoxicity , medicine , ejection fraction , doxorubicin , ventricle , chemotherapy , heart failure , cardiology , trastuzumab , magnetic resonance imaging , nuclear medicine , cancer , radiology , breast cancer
Background Doxorubicin and doxorubicin‐trastuzumab combination chemotherapy have been associated with cardiotoxicity that eventually leads to heart failure and may limit dose‐effective cancer treatment. Current diagnostic strategies rely on decreased ejection fraction (EF) to diagnose cardiotoxicity. Purpose The aim of this study is to explore the potential of cardiac MR (CMR) imaging to identify imaging biomarkers in a mouse model of chemotherapy‐induced cardiotoxicity. Methods A cumulative dose of 25 mg/kg doxorubicin was administered over three weeks using subcutaneous pellets ( n = 9, Dox). Another group (n = 9) received same dose of Dox and a total of 10 mg/kg trastuzumab (DT). Mice were imaged at baseline, 5/6 weeks and 10 weeks post‐treatment on a 7T MRI system. The protocol included short‐axis cine MRI covering the left ventricle (LV) and mid‐ventricular short‐axis tissue phase mapping (TPM), pre‐ and post‐contrast T1 mapping, T2 mapping and Displacement Encoding with Stimulated Echoes (DENSE) strain encoded MRI. EF, peak myocardial velocities, native T1, T2, extracellular volume (ECV), and myocardial strain were quantified. N = 7 mice were sacrificed for histopathologic assessment of apoptosis at 5/6 weeks. Results Global peak systolic longitudinal velocity was reduced at 5/6 weeks in Dox (0.6 ± 0.3 vs 0.9 ± 0.3, p = 0.02). In the Dox group, native T1 was reduced at 5/6 weeks (1.3 ± 0.2 ms vs 1.6 ± 0.2 ms, p = 0.02), and relatively normalized at week 10 (1.4 ± 0.1 ms vs 1.6 ± 0.2 ms, p > 0.99). There was no change in EF and other MRI parameters and histopathologic results demonstrated minimal apoptosis in all mice (~1–2 apoptotic cell/high power field), suggesting early‐stage cardiotoxicity. Conclusions In a mouse model of chemotherapy‐induced cardiotoxicity using doxorubicin and trastuzumab, advanced CMR shows promise in identifying treatment‐related decrease in myocardial velocity and native T1 prior to the onset of cardiomyocyte apoptosis and reduction of EF.