Relationship between cardiovascular dysfunction and weight loss in patients with esophageal cancer: results from a Cardiac MRI-Based Study

Background Cardiovascular dysfunction occurs in one-third of esophageal cancer patients, potentially impairing oncological treatment outcomes. Cardiac MRI (CMR) is a modern imaging modality evaluating both functional and tissue properties of the myocardium. Purpose Our study aimed to examine cachexia-related cardiovascular changes in surgery candidates with esophageal cancer. Methods This prospective study analyzed pre-treatment CMR findings in esophageal cancer patients, comparing them to weight loss. Patients were grouped by >10% or ≤10% body weight loss. Associations between weight loss and cardiac parameters were assessed using Pearson correlation and linear regression in R with a significance level of 0.05. Results Among 41 patients, most were male (30/41), with a mean age of 63 ± 11.9 years. In Group 1 (n=21), the average weight loss was 18%, accompanied by higher T1 values (1003 ms [954–1,015] vs. 958 ms [900–968], p=0.006) and a trend toward lower stroke volume (70 ml [49–81] vs. 79 ml [70–92], p=0.12) compared to Group 2, where the average weight loss was 6%. The percentage of weight loss showed a weak negative correlation with left ventricular muscle mass (r=-0.343, p=0.028), while stroke volume had a strong positive correlation with left ventricular muscle mass (r=0.668, p<0.001). T1 values were weakly positively correlated with the percentage of weight loss (r=0.392, p=0.032). Linear regression revealed a significant positive association between weight loss and T1 values (β=3.31, p=0.011) and a significant negative association with left ventricular muscle mass (β=-0.13, p=0.028). Conclusions Our findings indicate that weight loss >10% has a detrimental effect on cardiovascular function, reducing left ventricular muscle mass and increasing T1 values, which may indicate myocardial tissue damage in patients with eosophageal cancer. These changes could compromise oncological treatment outcomes and survival, emphasizing the importance of early diagnosis and comprehensive management.