Evaluation of cardiac magnetic resonance imaging parameters in cancer patients receiving chekpoint-inhibitor therapy

Against the background of immune antitumour therapy, the number of documented cases of cardiovascular complications is increasing. These studies emphasise the ability of contrast-enhanced magnetic resonance imaging in vivo to provide detailed information on myocardial damage of different etiologies Objective. To evaluate cardiac magnetic resonance imaging parameters in cancer patients receiving chekpoint-inhibitor therapy. Materials and methods. The prospective study included 85 patients (58 men, 27 women), mean age 51.3±8.37 years. The H2FPEF scale, Scale for Assessment of Clinical Status of Patient with Chronic Heart Failure (SACCHF) was evaluated. If new or progression of existing symptoms associated with heart failure occurred, magnetic resonance imaging (MRI) of the heart with contrast enhancement was performed. Results. New and/or progression of existing symptoms associated with heart failure was noted in 16 patients over a three-month period. The mean H2FPEF score was 5.0 [4.0; 7.0] and SCOX score was 6.0 [4.0; 7.0]. According to the data of cardiac MRI with contrasting in 18.75% of patients (n=3) fibrosis zones were revealed, and in 1 patient – a combination of edema and fibrosis zones. There was a decrease in the basal thickness of the anterior wall in diastole (p=0.013) and systole (p=0.011) of the left ventricle (LV), of the lateral wall in LV systole (p=0.002), of the posterior wall in LV systole (p=0.007); decrease in the thickness of the middle part of the anterior wall (p=0.03), apical part of the interventricular septum in LV systole (p=0.009); decrease in LV ejection fraction (p=0.001), increase in LV end-diastolic (p=0.004) and end-systolic volumes (p=0.004). Conclusions. According to the data of contrast-enhanced cardiac MRI in 3 (18.75%) of cancer patients receiving chekpoint-inhibitors, structural and functional changes of the left ventricular myocardium associated with the formation of foci of oedema, foci of fibrosis were revealed. In the group of patients with the presence of oedema and/or fibrosis, a decrease in the basal thickness of the anterior wall in systole and diastole, of the lateral wall in systole, and of the posterior wall in systole of the left ventricle was revealed. There was a decrease in the thickness of the middle section of the anterior wall, apical section of the interventricular septum in systole of the left ventricle. The revealed structural changes were associated with decreased ejection fraction, increased end-diastolic and end-systolic volumes of the left ventricle.