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

Authors

Gamonal-Moran Gamonal-Moran Universidad Ricardo Palma - Clínica Good Hope, Lima, Perú. https://orcid.org/0009-0002-7309-2498
Dragonetti Dragonetti Hospital Alemán, Buenos Aires, Argentina. https://orcid.org/0000-0001-8711-3961
Almeida Arostegui Almeida Arostegui Hospital Universitario Nuestra Señora del Rosario, Madrid, España. https://orcid.org/0000-0001-8190-3508
Quispe-Silvestre Quispe-Silvestre 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

Keywords:

Cardio-Oncology, Biomarkers, Immunotherapy, Diagnostic Imaging

Abstract

This scoping review, conducted in accordance with the PRISMA-ScR methodology, maps the available scientific evidence on cardiac magnetic resonance (CMR) abnormalities associated with immune checkpoint inhibitorinduced myocarditis (ICI-M). Twenty studies published between 2019 and 2025 were analysed, highlighting alterations in left ventricular function (left ventricular ejection fraction [LVEF]), myocardial oedema detected by T2-weighted sequences, and fibrosis identified as late gadolinium enhancement (LGE). Key diagnostic criteria included elevated extracellular volume (ECV), impaired global longitudinal strain (GLS), and abnormal T1 and T2 relaxation times. Of the included studies, most were retrospective, followed by case reports and prospective studies. The therapies most frequently associated with ICI-M involved combinations of anti-PD1 and antiCTLA4 agents. Cardiac magnetic resonance (CMR) has proven to be a highly sensitive, non-invasive tool for detecting myocardial involvement, even before the elevation of biomarkers such as troponins. The importance of using advanced tools like CMR to assess cardiovascular complications associated with myocarditis is highlighted. Parameters such as LVEF, GLS, LGE, and ECV provide valuable information on ventricular function and structural alterations related to myocarditis. These findings allow us to identify knowledge gaps and guide future research on the use of CMR in myocarditis.

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