Parámetros de resonancia magnética cardiaca asociados a miocarditis por inmunoterapia en pacientes oncológicos: una revisión de alcance

Karen Valeria Karen Valeria; Laura Cristina Laura Cristina; Nicolás Nicolás; Edgar Edgar

doi:10.47487/apcyccv.v7i1.586

Autores/as

Karen Valeria Karen Valeria Universidad Ricardo Palma - Clínica Good Hope, Lima, Perú. https://orcid.org/0009-0002-7309-2498
Laura Cristina Laura Cristina Hospital Alemán, Buenos Aires, Argentina. https://orcid.org/0000-0001-8711-3961
Nicolás Nicolás Hospital Universitario Nuestra Señora del Rosario, Madrid, España. https://orcid.org/0000-0001-8190-3508
Edgar Edgar Universidad Federico Villarreal - Instituto Peruano de Oncología y Radioterapia, Lima, Perú. https://orcid.org/0000-0003-4431-1882

DOI:

https://doi.org/10.47487/apcyccv.v7i1.586

Palabras clave:

Cardiooncología, Biomarcadores, Inmunoterapia Activa, Diagnóstico por Imagen

Resumen

Esta revisión de alcance, basada en la metodología PRISMA-ScR, mapea la evidencia científica disponible sobre parámetros alterados en la resonancia magnética cardíaca (RMC) asociados con miocarditis inducida por inhibidores del punto de control inmunitario (ICI-M). Se analizaron veinte estudios publicados entre 2019 y 2025, destacando alteraciones en la función ventricular izquierda (FEVI), edema miocárdico detectado por secuencias ponderadas en T2 y fibrosis identificada como realce tardío de gadolinio (RTG). Los principales criterios diagnósticos incluyeron parámetros como volumen extracelular (VEC) elevado, strain longitudinal global (SLG) alterado y tiempos de relajación T1/T2 anormales. Del total de estudios revisados, la mayoría fueron retrospectivos, seguidos por informes de casos y estudios prospectivos. Las terapias más frecuentemente asociadas con ICI-M involucraron combinaciones de agentes anti-PD1 y anti-CTLA4. La RMC ha demostrado ser una herramienta altamente sensible y no invasiva para detectar la afectación miocárdica, incluso en ausencia de alteraciones significativas en biomarcadores en algunos casos reportados. Se destaca la importancia de utilizar herramientas avanzadas como la RMC para evaluar las complicaciones cardiovasculares asociadas con la miocarditis. Parámetros como la FEVI, el SLG, el RTG y el VEC proporcionan información valiosa sobre la función ventricular y las alteraciones estructurales relacionadas con la miocarditis. Estos hallazgos nos permiten identificar lagunas en el conocimiento y orientar la investigación futura sobre el uso de la RMC en la miocarditis.

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