Evidence map›Paper›PMID 38243390›Full record

ArticleESC heart failure2024

Cardiac magnetic resonance-based layer-specific strain in immune checkpoint inhibitor-associated myocarditis.

Zheng Li, Rui Zhao, Cong Wang, Yan Wang, Jinyi Lin, Shihai Zhao, Jiahui Chen, Yuhong Zhou, Tianshu Liu, Feng Wang and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Zheng LiDepartment of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.
Rui ZhaoDepartment of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
Cong WangShanghai Institute of Cardiovascular Diseases, Shanghai, China.
Yan WangDepartment of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Jinyi LinShanghai Institute of Cardiovascular Diseases, Shanghai, China.
Shihai ZhaoShanghai Institute of Medical Imaging, Shanghai, China.
Jiahui ChenShanghai Institute of Cardiovascular Diseases, Shanghai, China.
Yuhong ZhouDepartment of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Tianshu LiuDepartment of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Feng WangDepartment of Medical Oncology, Qinhuai Medical Area of General Hospital of Eastern Theater Command, Nanjing, China.
Xianhong ShuDepartment of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.
Mengsu ZengShanghai Institute of Medical Imaging, Shanghai, China.
Leilei ChengDepartment of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0003-0677-7892
Sun Yat-sen University · CNFudan University · CNShanghai Medical College of Fudan University · CNJohn H. Stroger, Jr. Hospital of Cook County · USNanjing General Hospital of Nanjing Military Command · CN

Funding

National Natural Science Foundation of China 82170359The Clinical Research Project of Zhongshan Hospital 2020ZSLC21The Shanghai Municipal Health Commission Fund 202040344The Standardized Technology Management and Promotion Project of Shanghai Shenkang Hospital Development Center SHDC22023207The State Key Clinical Specialty Construction Project YW2021-002The Youth Fund of Zhongshan Hospital, Fudan University 2020ZSQN74
6 · The paper itself

Abstract

aimsTo assess the different imaging characteristics between corticosteroid-sensitive (CS) and corticosteroid-refractory (CR) immune checkpoint inhibitor-associated myocarditis (ICIaM) with cardiac magnetic resonance (CMR) and the potential CMR parameters in the early detection of CR ICIaM. METHODS AND

resultsThirty-five patients diagnosed with ICIaM and 30 age and gender-matched cancer patients without a history of ICI treatment were enrolled. CMR with contrast was performed within 2 days of clinical suspicion. Left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) were assessed by CMR. LV sub-endocardial (GLSendo) and sub-epicardial (GLSepi) global longitudinal strains were quantified by offline feature tracking analysis. CS and CR ICIaM were defined based on the trend of Troponin I and clinical course during corticosteroid treatment. All 35 patients presented with non-fulminant symptoms upon initial assessment. Twenty patients (57.14%) were sensitive, and 15 (42.86%) were refractory to corticosteroids. Compared with controls, 22 patients (62.86%) with ICIaM developed LGE. LVEF decreased in CR ICIaM compared with the CS group and controls. GLSendo (-14.61 ± 2.67 vs. -18.50 ± 2.53, P < 0.001) and GLSepi (-14.75 ± 2.53 vs. -16.68 ± 2.05, P < 0.001) significantly increased in patients with CR ICIaM compared with the CS ICIaM. In patients with CS ICIaM, although GLSepi (-16.68 ± 2.05 vs. -19.31 ± 1.80, P < 0.001) was impaired compared with the controls, GLSendo was preserved. There was no difference in CMR parameters between LGE-positive and negative groups. LVEF, GLSendo, and GLSepi were predictors of CR ICIaM. When LVEF, GLSendo, and GLSepi were included in multivariate analysis, only GLSendo remained an independent predictor of CR ICIaM (OR: 2.170, 95% CI: 1.189-3.962, P = 0.012). A GLSendo of ≥-17.10% (sensitivity, 86.7%; specificity, 80.0%; AUC, 0.860; P < 0.001) could predict CR ICIaM in the ICIaM cohort. Kaplan-Meier analysis showed that in patients with impaired GLSendo of ≥-17.10%, cardiovascular adverse events (CAEs) occurred much earlier than in patients with preserved GLSendo of <-17.10% (Log-rank test P = 0.017).

conclusionsCR and CS ICIaM demonstrated different functional and morphological characteristics in different myocardial layers. An impaired GLSendo could be a helpful parameter in early identifying corticosteroid-refractory individuals in the ICIaM population.

Indexed as

MyocarditisAdrenal Cortex HormonesContrast MediaEarly Detection of CancerGadoliniumHumansImmune Checkpoint InhibitorsMagnetic Resonance Imaging, CineMagnetic Resonance SpectroscopyStroke VolumeVentricular Function, LeftAdrenal Cortex HormonesContrast MediaGadoliniumImmune Checkpoint InhibitorsCardiac magnetic resonanceGlobal longitudinal strainImmune checkpoint inhibitorLate gadolinium enhancementMyocarditis

Identifiers

PMID38243390
PMCPMC10966230
OpenAlexW4391053098

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.