Evaluation of Anthracycline-Induced Cardiotoxicity Using Proton Magnetic Resonance Spectroscopy Compared With Cardiac Functional Parameters　― An Animal Study ―

Abstract

Background: Anthracycline-induced cardiotoxicity (AIC) poses significant challenges due to its severe adverse effects, limiting the use of anthracycline drugs (ATC). Early detection and intervention are pivotal, yet current diagnostic methods lack sensitivity.

Methods and Results: In a prospective animal study, 20 rabbits were administered adriamycin weekly and underwent cardiac magnetic resonance (CMR) scanning every 2 weeks. Ventricular function and myocardial metabolite content were assessed. Using a linear mixed model, we determined the earliest CMR-sensitive time and diagnostic thresholds for AIC detection via proton magnetic resonance spectroscopy (¹H-MRS). Results showed that Lipid1 increased significantly earlier at week 6 compared to the decreased left ventricular ejection fraction (LVEF) at week 8 (P<0.05). ROC analysis revealed that a Lipid1 cutoff value of 2.60 had the best diagnostic accuracy for AIC at week 6, with an area under the curve of 0.745, specificity of 0.71, and sensitivity of 0.80 (95% CI: 0.575–0.916). Lipid1 also demonstrated a moderately negative correlation with LVEF (r=–0.418, P<0.01).

Conclusions: ¹H-MRS-detected Lipid1 increased at week 6 after anthracycline injection, offering earlier diagnosis of AIC compared to conventional LVEF biomarkers.