Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis
Background: The complex process of cardiac magnetic resonance (CMR) and the uncertainty of each parameter in the diagnosis and prognosis of cardiotoxicity limit its promotion in the cardiac evaluation of patients treated with immune checkpoint inhibitors (ICI)....
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| Language: | English |
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IMR Press
2025-02-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/2/10.31083/RCM25508 |
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| author | Jialian Li Yanwei Li Li Tao Chuan Zhang Zhong Zuo |
| author_facet | Jialian Li Yanwei Li Li Tao Chuan Zhang Zhong Zuo |
| author_sort | Jialian Li |
| collection | DOAJ |
| description | Background: The complex process of cardiac magnetic resonance (CMR) and the uncertainty of each parameter in the diagnosis and prognosis of cardiotoxicity limit its promotion in the cardiac evaluation of patients treated with immune checkpoint inhibitors (ICI). Methods: A comprehensive search was conducted across PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Cochrane databases for relevant articles published up until September 28, 2024. Results: After screening, 8 articles were included in this study. The analysis revealed that following ICI treatment, the left ventricular global longitudinal strain (GLS) increased significantly [weighted mean difference (WMD) 2.33; 95% confidence interval (CI) 1.26, 3.41; p < 0.01], while the global radial strain (GRS) decreased [WMD –4.73; 95% CI –6.74, –2.71; p < 0.01]. Additionally, T1 and T2 values increased [standardized mean difference (SMD) 1.14; 95% CI 0.59, 1.68; p < 0.01] and [SMD 1.11; 95% CI 0.64, 1.58; p < 0.01], respectively. An elevated T2 was associated with a higher occurrence of major adverse cardiovascular events (MACE), with a hazard ratio of 1.36 (95% CI 1.12, 1.64). Conclusions: Our findings demonstrate that T1, T2, and GLS increase, while GRS decreases following ICI administration. By consolidating these critical metrics, we propose a streamlined, abbreviated (non-contrast) CMR protocol that can be completed within 15 minutes, thereby facilitating the integration of CMR in cardio-oncology. The PROSPERO registration: CRD42023437238, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437238. |
| format | Article |
| id | doaj-art-a5d7dbef461844e79c6f96b9bf1eac19 |
| institution | DOAJ |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-a5d7dbef461844e79c6f96b9bf1eac192025-08-20T02:55:06ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-02-012622550810.31083/RCM25508S1530-6550(24)01671-5Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-AnalysisJialian Li0Yanwei Li1Li Tao2Chuan Zhang3Zhong Zuo4Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, ChinaDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, ChinaBackground: The complex process of cardiac magnetic resonance (CMR) and the uncertainty of each parameter in the diagnosis and prognosis of cardiotoxicity limit its promotion in the cardiac evaluation of patients treated with immune checkpoint inhibitors (ICI). Methods: A comprehensive search was conducted across PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Cochrane databases for relevant articles published up until September 28, 2024. Results: After screening, 8 articles were included in this study. The analysis revealed that following ICI treatment, the left ventricular global longitudinal strain (GLS) increased significantly [weighted mean difference (WMD) 2.33; 95% confidence interval (CI) 1.26, 3.41; p < 0.01], while the global radial strain (GRS) decreased [WMD –4.73; 95% CI –6.74, –2.71; p < 0.01]. Additionally, T1 and T2 values increased [standardized mean difference (SMD) 1.14; 95% CI 0.59, 1.68; p < 0.01] and [SMD 1.11; 95% CI 0.64, 1.58; p < 0.01], respectively. An elevated T2 was associated with a higher occurrence of major adverse cardiovascular events (MACE), with a hazard ratio of 1.36 (95% CI 1.12, 1.64). Conclusions: Our findings demonstrate that T1, T2, and GLS increase, while GRS decreases following ICI administration. By consolidating these critical metrics, we propose a streamlined, abbreviated (non-contrast) CMR protocol that can be completed within 15 minutes, thereby facilitating the integration of CMR in cardio-oncology. The PROSPERO registration: CRD42023437238, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437238.https://www.imrpress.com/journal/RCM/26/2/10.31083/RCM25508cardiac magnetic resonanceimmune checkpoint inhibitorscardiotoxicityglobal longitudinal strainglobal radial straint1t2 |
| spellingShingle | Jialian Li Yanwei Li Li Tao Chuan Zhang Zhong Zuo Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis Reviews in Cardiovascular Medicine cardiac magnetic resonance immune checkpoint inhibitors cardiotoxicity global longitudinal strain global radial strain t1 t2 |
| title | Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis |
| title_full | Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis |
| title_fullStr | Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis |
| title_short | Diagnostic and Prognostic Value of Cardiac Magnetic Resonance for Cardiotoxicity Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis |
| title_sort | diagnostic and prognostic value of cardiac magnetic resonance for cardiotoxicity caused by immune checkpoint inhibitors a systematic review and meta analysis |
| topic | cardiac magnetic resonance immune checkpoint inhibitors cardiotoxicity global longitudinal strain global radial strain t1 t2 |
| url | https://www.imrpress.com/journal/RCM/26/2/10.31083/RCM25508 |
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