CMR assessment of myocardial mechanics and tissue characterization in patients treated with Anthracycline chemotherapy for acute myeloid leukaemia

Background Anthracycline-associated cardiomyopathy is a progressive, dose-dependent complication of Anthracycline chemotherapy. The period between Anthracycline therapy and onset of overt heart failure is often years, even decades, and as such Anthracyclines appear to initiate a myocardial injury that remains clinically silent for a substantial period of time. Left ventricular (LV) ejection fraction (EF) is often preserved during this latent period. A more sensitive marker of Anthracycline-associated myocardial injury would allow earlier diagnosis, hence potentially earlier initiation of cardioprotective therapy, and better prognostication. We assessed the relationship between cumulative Anthracycline dose and myocardial function (global and regional) and myocardial fibrosis (focal and diffuse) in patients who had previously received Anthracycline chemotherapy for acute myeloid leukaemia (AML) with normal or near normal LV EF.