PURPOSE: To use delayed enhancement cardiac magnetic resonance (DE-CMR) as a reference standard to evaluate the prevalence and
Abstract
PURPOSE: To use delayed enhancement cardiac magnetic resonance (DE-CMR) as a reference standard to evaluate the prevalence and predictors of right atrial (RA) thrombus.
METHODS: In this retrospective study, 130 cancer patients with central venous catheters undergoing CMR from August 2012-January 2018 were included. CMR (cine-CMR and DE-CMR) and echocardiography were interpreted for RA thrombus blinded to other imaging results and clinical data. RA thrombus properties including the number of discrete masses, size, total thrombus area, and perimeter were also assessed. Cine-CMR was also used to quantify cardiac structure and function as markers of RA thrombus. Student's t-test was used to assess continuous variables; chi-square or Fisher's exact test were used to assess categorical variables.
RESULTS: 31/130 (24%) patients had RA thrombus on DE-CMR. Echocardiography (attained in 64% of the study population) demonstrated moderate sensitivity and specificity (75%, 90% respectively) in relation to DE-CMR; cine-CMR performance was higher (sensitivity 90%, specificity 98%). Patients with and without RA thrombus had similar right-sided structure/function and cancer diagnosis. Catheter depth approached significance in patients with RA thrombus (p = 0.05). 13% of patients with RA thrombus had concomitant pulmonary embolism within 60 days of CMR vs. 2% of patients without RA thrombus (p = 0.03). Embolic events were independent of RA thrombus size (p = 0.66).
CONCLUSION: Morphologic imaging by cine-CMR and echocardiography provide limited diagnostic utility for RA thrombus as established by DE-CMR tissue characterization. Catheter-associated RA thrombus occurs independently of right-sided structure or function and is associated with clinical embolic events and catheter depth.
PMID: 32036237 [PubMed - as supplied by publisher]
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pubmed: caandvteortroorpul
Interobserver agreement of 18F-Fluorodeoxyglucose Positron-Emission Tomography combined with low-dose Computed Tomography for occult cancer screening in patients with unprovoked venous thromboembolism.
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Interobserver agreement of 18F-Fluorodeoxyglucose Positron-Emission Tomography combined with low-dose Computed Tomography for occult cancer screening in patients with unprovoked venous thromboembolism.
Thromb Res. 2020 Jan 30;188:25-27
Authors: Robin P, Grewal RK, Le Roux PY, Le Gal G, Salaun PY
PMID: 32036158 [PubMed - as supplied by publisher]
15:48
Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)
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pubmed: ctoall&ca or conall
Non-Invasive Hemodynamic Whole-Body Bioimpedance Indices for the Early Detection of Cancer Treatment-Related Cardiotoxicity: A Retrospective Observational Study.
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Non-Invasive Hemodynamic Whole-Body Bioimpedance Indices for the Early Detection of Cancer Treatment-Related Cardiotoxicity: A Retrospective Observational Study.
Cardiology. 2020 Feb 07;:1-6
Authors: Schamroth Pravda N, Lev S, Itzhaki Ben Zadok O, Kornowski R, Iakobishvili Z
Abstract
INTRODUCTION: Patients undergoing chemotherapy are extremely vulnerable to cardiotoxicity. Early detection of cardiac dysfunction is of vital importance to optimize the management of these patients.
OBJECTIVE: The aim of this study was to test the effectiveness of non-invasive hemodynamic whole-body bioimpedance (WBI) technology as a modality to detect heart failure in patients undergoing chemotherapy treatment.
METHODS: This retrospective observational trial included 84 patients treated at the cardio-oncology outpatient clinic of the Rabin Medical Center. Clinical assessments were performed including biomarker testing and measurement of hemodynamic and volume status parameters as measured by WBI.
RESULTS: We included 84 patients with a median age of 64.8 years, and 40.5% were males. Clinical heart failure was detected in 43% of the whole group. Patients were divided into two groups according to baseline NT-proBNP levels with a cut-off of 900 pg/mL. Left ventricular ejection fraction did not differ between the groups. Those with NT-proBNP >900 pg/mL had lower levels of stroke index, cardiac index, and Granov-Goor index (GGI; 25.9 vs. 34.0, 2.0 vs. 2.3, 8.3 vs. 11.4, respectively, with p < 0.001 for all comparisons). The optimal cut-off value for the GGI to detect NT-proBNP >900 pg/mL was 8.3. The area under the curve of a GGI cut-off <8.3900 pg/mL was 0.81 (positive predictive value 95% and negative predictive value 72%), with a 51% sensitivity and 98% specificity.
CONCLUSION: GGI, a parameter measured by WBI, can reliably correlate to biomarker evidence of heart failure in patients after chemotherapy. Its use as a screening tool for cardiotoxicity in patients with ongoing anticancer therapy is promising.
PMID: 32036358 [PubMed - as supplied by publisher]
11 February 2020
13:03
Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)
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pubmed: ctoall&ca or conall
Targeting GPCRs Against Cardiotoxicity Induced by Anticancer Treatments.
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Targeting GPCRs Against Cardiotoxicity Induced by Anticancer Treatments.
Front Cardiovasc Med. 2019;6:194
Authors: Audebrand A, Désaubry L, Nebigil CG
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