New Insights in Early Detection of Anticancer Drug-Related Cardiotoxicity Using Perfusion and Metabolic Imaging

Farah Cadour (1, 2) , Franck Thuny (3, 4) , Joevin Sourdon (1, 2)

1 CRMBM - Centre de résonance magnétique biologique et médicale
2 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM]
3 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
4 Hôpital Nord [CHU - APHM]

Cardio-oncology requires a good knowledge of the cardiotoxicity of anticancer drugs, their mechanisms, and their diagnosis for better management. Anthracyclines, anti-vascular endothelial growth factor (VEGF), alkylating agents, antimetabolites, anti-human epidermal growth factor receptor (HER), and receptor tyrosine kinase inhibitors (RTKi) are therapeutics whose cardiotoxicity involves several mechanisms at the cellular and subcellular levels. Current guidelines for anticancer drugs cardiotoxicity are essentially based on monitoring left ventricle ejection fraction (LVEF). However, knowledge of microvascular and metabolic dysfunction allows for better imaging assessment before overt LVEF impairment. Early detection of anticancer drug-related cardiotoxicity would therefore advance the prevention and patient care. In this review, we provide a comprehensive overview of the cardiotoxic effects of anticancer drugs and describe myocardial perfusion, metabolic, and mitochondrial function imaging approaches to detect them before over LVEF impairment.

Mots clés: cardio-oncology; cardiotoxicity; perfusion; metabolism; mitochondria; magnetic resonance spectroscopy or MRS; magnetic resonance imaging; nuclear imaging

Domaines: Pharmacologie; Imagerie; Cardiologie et système cardiovasculaire

Farah Cadour, Franck Thuny, Joevin Sourdon. New Insights in Early Detection of Anticancer Drug-Related Cardiotoxicity Using Perfusion and Metabolic Imaging. Frontiers in Cardiovascular Medicine, 2022, 9, pp.813883. ⟨10.3389/fcvm.2022.813883⟩. ⟨hal-03589683⟩