1348707 - Prevalence of Left Ventricular Non-Compaction Diagnosed by Cardiovascular Magnetic Resonance in Children and Young Adults with Chemotherapy Induced Cardiomyopathy

Cardiovascular magnetic resonance (CMR) is commonly used to diagnose left ventricular non-compaction (LVNC). No studies have described LVNC in children and young adults exposed to cardiotoxic cancer therapies. The aim of this study was to determine the prevalence of LVNC in the setting of chemotherapy induced cardiomyopathy.

Methods:

We performed a retrospective chart review of pediatric and young adult cancer patients with echocardiographic evidence of chemotherapy-induced cardiomyopathy referred for CMR between January 2014 – January 2022. Clinical data (demographics, cancer diagnosis, therapeutic exposures, and cardiovascular medications) were obtained at time of CMR. Ventricular volumes, ejection fractions, LV global mass (LVGM), LV compacted mass (LVCM), left atrial volume (LAV), and late gadolinium enhancement (LGE) were obtained. LV end-diastolic volume defined with LVCM. Noncompacted mass (LVNCM) was calculated as LVGM-LVCM, noncompacted mass percentage (LVNCM%) was calculated as LVNCM/LVGM (Figure 1). Papillary muscle mass was included in the LVCM.  The non-compacted to compacted (NC/C) ratio was measured from multiple CMR views with the maximum reported. An NC/C ratio >2.3 and LVNCM% > 20 was considered diagnostic for LVNC. CMR measurements were compared using a non-parametric Kruskal Wallis test and patient characteristics using chi-square test.

Results:

Among 81 cancer patients with chemotherapy-induced cardiomyopathy, 18 (22%) met diagnostic criteria for LVNC. Those with LVNC had a lower weight and BSA but no difference on gender, race, cancer diagnosis, age at diagnosis, stem cell transplantation, or use of cardiovascular medications compared to those without LVNC (Table 1). Based upon a 16-segment myocardial model, patients with LVNC had non-compaction in a range of 1-4 segments isolated only to the apical regions. LVGM, LVNCM, LVNCM%, and NC/C ratio were significantly increased among those with LVNC compared to those without (Table 2). Papillary muscle mass was smaller among those with LVNC compared to those without (Table 2). Fewer patients with LVNC had LGE (6% vs. 13%, p=< 0.001).

Conclusion:

LVNC is prevalent among children and young adults with chemotherapy-induced cardiomyopathy. Further study is needed to determine associations with cancer diagnoses and/or treatment exposures.