Cardiac MRI for the assessment of early chemotherapeutic cardiac injury and toxicity

Background Chemotherapeutically induced myocardial injury continues to pose a major problem. The exact mechanism of drug-related cardiomyopathy (DRC) is still poorly understood. An early diagnosis of cardiotoxicity and the ability to predict patients at risk are important for preventing chronic heart failure. The guidelines for noninvasive cardiac imaging to screen for DRC show limitations in early identification of patients at risk, currently relying on left ventricular (LV) ejection fraction (EF) for establishing high risk. Contrast enhanced cardiac magnetic resonance imaging (ce-CMR) may offer a stronger screening approach, especially since it can assess the right ventricle (RV) and detect early changes in response to chemotherapy.