Key result
Untreated DLBCL is linked to subclinical myocardial injury, featuring higher native T1 and reduced strain.
Why the study?
Does treatment-naive diffuse large B cell lymphoma cause subclinical myocardial alterations detectable by cardiac magnetic resonance compared to healthy controls?
Case-Control (n=100)
Assessor-blinded
No
Does treatment-naive diffuse large B cell lymphoma cause subclinical myocardial alterations detectable by cardiac magnetic resonance compared to healthy controls?
Absolute Event Rate: 1007% vs 976%
p-value: p=<0.001
Treatment-naive patients with diffuse large B cell lymphoma exhibit subclinical myocardial alterations detectable by CMR, including elevated native T1 and reduced global longitudinal strain, suggesting cancer-related myocardial remodeling occurs prior to cardiotoxic therapy.
PURPOSE: Functional and myocardial tissue modifications can occur in treatment-naïve cancer patients, driven by uncontrolled inflammation and neuro-hormonal activation. These mechanisms may result in myocardial alterations that serve as subclinical imaging markers of potential cardiac dysfunction. This study aims to evaluate the role of cardiac magnetic resonance in investigating cancer-associated immune activation and identifying early biomarkers of myocardial damage in treatment-naive cancer patients. METHODS: This prospective study enrolled 100 participants, including 50 treatment-naive cancer patients affected by diffuse large B cell lymphoma and 50 age- and gender-matched healthy controls. All participants underwent comprehensive cardiac magnetic resonance imaging before starting chemotherapy. Correlation analysis was conducted to identify differences in myocardial tissue characterization and functional parameter between the two groups. RESULTS: Native T1 values were significantly higher in the cancer cohort compared to controls (1007 ± 29 ms vs. 976 ± 29 ms; p < 0.001), while global longitudinal strain was significantly reduced (- 14 ± 2% vs. - 22 ± 6%; p < 0.001). Correlation analysis identified native T1 as an independent predictor of global longitudinal strain impairment (R = - 0.3; p < 0.05). No significant differences in left ventricular mass were observed, suggesting that myocardial tissue changes may precede structural remodeling. CONCLUSION: Treatment-naive cancer patients exhibit subclinical myocardial alterations, characterized by elevated native T1 and reduced global longitudinal strain. Cardiac magnetic resonance emerges as a valuable tool for identifying early biomarkers of myocardial dysfunction, offering opportunities for risk stratification and proactive management in cardio-oncology.
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Catapano et al. (2026) conducted a case-control in Diffuse large B cell lymphoma (n=100). Treatment-naive diffuse large B cell lymphoma vs. Healthy controls was evaluated on Native T1 mapping (p=<0.001). Treatment-naive patients with diffuse large B cell lymphoma exhibited significant subclinical myocardial alterations, including elevated native T1 values (1007 vs 976 ms) and reduced global longitudinal strain (-14% vs -22%), compared to healthy controls.
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