Cardio Oncology

1357672 - Utility of Cardiac Magnetic Resonance for Optimal Diagnosis and Treatment in Patients with Cardiac Masses in a Latin-American Heart Center

Friday, January 27, 2023

10:20 AM – 11:00 AM

Location: Pacific Jewel

Presenting Author(s)

GO

Gabriel Oliver, MD

Cardiology Fellow
Fundacion Cardioinfantil, Colombia

Primary Author(s)

GO

Gabriel Oliver, MD

Cardiology Fellow
Fundacion Cardioinfantil, Colombia

Co-Author(s)

MV

Maria-Daniela Valderrama-Achury, MD

Research Assistant
Fundación Cardioinfantil, Colombia
CO

Carlos Obando, MD

Cardiothoracic Surgeon
Fundacion cardioinfantil, Colombia
Héctor M. Medina, MD

Cardiac imaging
Fundación Cardioinfantil–La Cardio, Bogotá, Colombia
Bogotá, Distrito Capital de Bogota, Colombia
JF

Julian-Francisco Forero-Melo, MD

Cardiac imaging
Fundación Cardioinfantil–La Cardio, Bogotá, Colombia, Colombia
CJ

Claudia-Patricia Jaimes-Castellanos, MD

Cardiac imaging
Fundación Cardioinfantil–La Cardio, Bogotá, Colombia, Colombia
SL

Stephany Luna, MD

Cardiology Fellow
Fundacion Cardioinfantil, Colombia
Carlos-Eduardo Guerrero-Chalela, MD

Cardiac imaging/Adult Congenital Heart Disease
Fundación Cardioinfantil–La Cardio, Bogotá, Colombia, Distrito Capital de Bogota, Colombia
JG

Julian Gelves-Meza, MD

Cardiac Imaging
Fundacion Cardioinfantil, Colombia
HH

Hugo Herrera, MD

Pathologist
Fundacion cardioinfantil, Colombia
TC

Tomas Chalela, MD

Cardiothoracic Surgeon
Fundacion Cardioinfantil, Colombia
JU

Juan P. Umaña, MD

Cardiothoracic Surgeon
Fundacion Cardioinfantil, Colombia

Disclosure(s):

Carlos-Eduardo Guerrero-Chalela, MD: No financial relationships to disclose

Background:

In developing countries, there is paucity of data regarding the role of CMR for characterization of cardiac masses. We aim to report the utilization of CMR in a tertiary care center in these patients in Latin America and it's utility for guiding diagnosis and treatment.

Methods: Between 2016 and 2021, all CMR’s performed in our institution were reviewed. Clinical data were extracted from electronic medical records and CMR imaging protocol included, in all patients, T1W and T2W with and without fat suppression, perfusion and late gadolinium enhancement imaging sequences. In patients with suspicion of malignancy by CMR, percutaneous or open-heart biopsy/resection was performed. All-cause death was assessed using the National Database Registry.

Results: A total of 5002 patients were referred for CMR during the study period and 222 (4.4%) had a cardiac mass as the main indication. The mean age was 58 +/- 16 years old and 63.4% were men. Of all cardiac masses, 137/222 (61.7%) were thrombi and, of this sub-group, 62/137 (45%) were started on anticoagulation after CMR results. From all patients with cardiac masses, 25/222 (11%) had a cardiac biopsy/resection and the most frequent diagnosis was sarcoma (n=5; 20%) -including angiosarcoma, synovial, intimal, undifferentiated and mesenchymal (Fig 1), followed by fibroelastoma (n=4; 16% -Fig 2-) and myxoma (n=4;16%). The remaining diagnoses during biopsy were undifferentiated lymphoma, thrombus, cardiac fibroma and metastatic disease. The overall mortality of all patients diagnosed with a cardiac mass was 13% after a mean follow-up of 24 months.

Conclusion:

In a tertiary care center in Latin-America, patients with cardiac masses have a high mortality rate. CMR can provide unique anatomic and functional imaging to characterize these masses and helps in decision making including need for anticoagulation in patients with intra-cavitary thrombus and further guidance for cardiac biopsy or resection. Increasing access to CMR in our region may help improve the care of patients diagnosed with cardiac masses.