Changes in Cardiovascular Magnetic Resonanse T1 and T2 Mapping in Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation

Introduction

Despite the significant improvement in survival afforded by hematopoietic stem cell transplantation (HSCT), the therapy is associated with many complications, cardiovascular being one of them. Cardiovascular magnetic resonance (CMR) can depict changes at the tissue level, which could be a reflection of physiology and pathophysiology. In our study we aimed to evaluate the level and progress of diffuse myocardial fibrosis and edema in the heart using T1 and T2 mapping in patients one year after autologous HSCT.

Methods

Data of 26 patients undergoing autologous HSCT at the Department of Oncology and Hematology in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics between 2021 October and 2022 July was evaluated. Bioethics approvement for prospective study was obtained (No BE-2-96). Cardiac evaluation including cardiovascular magnetic resonance (CMR) was performed before stem cell mobilization and 12 ± 1 months after HSCT. CMR was performed using 3T MRI Siemens Magnetom Skyra, T1 and T2 mapping MOLLI (modified Look-Locker Inversion Recovery) sequences with motion correction (MOCO) were analysed using Syngo.via. Baseline mapping values were compered to values one year after transplantation. SPSS statistics 20 was used for statistical analysis (paired samples T test). Qualitative data is presented as absolute value (N) and percentage (%), quantitative parameters are given as average (m ± standard deviation).

Results

The mean age of patients was 56,7 ± 13,7 years (ranging from 18 to 74). Out of 26 patients there were 14 men (53,8%) and 12 women (46,2%). Mean T1 mapping value representing diffuse fibrosis significantly increased 12 months after transplantation. Mean T1 mapping value before HSCT was 1215,02 ± 35,2 ms and after 1243,07 ± 46,2 ms (p=0,014). Mean T2 mapping value representing edema did not change significantly. Mean T2 mapping value before HSCT was 38,28 ± 2,1 ms and 39,05 ± 1,8 ms after HSCT. (p=0,059).

Conclusions

The extent of diffuse fibrosis in the heart represented by elevation of T1 mapping value tend to increase one year after autologous HSCT. This may lead to further remodelling of the heart.