Cardiovascular toxicity of checkpoint inhibitors: review of associated toxicity and design of the Spanish Immunotherapy Registry of Cardiovascular Toxicity.

Immune checkpoint inhibitors (ICI) have changed the prognosis of many tumors. However, concerning associated cardiotoxicity has been reported. Little is known about the real-life incidence-specific surveillance protocols or the translational correlation between the underlying mechanisms and the clinical presentation of ICI-induced cardiotoxicity. The lack of data from prospective studies led us to review the current knowledge and to present the creation of the Spanish Immunotherapy Registry of Cardiovascular Toxicity (SIR-CVT), a prospective registry of patients receiving ICI that aims to examine the role of hsa-miR-Chr8:96, (a specific serum biomarker of myocarditis) in the early diagnosis of ICI-induced myocarditis. An exhaustive prospective cardiac imaging study will be performed before and during the first 12 months of treatment. The correlation between clinical, imaging, and immunologic parameters may improve our understanding of ICI-induced cardiotoxicity and enable simpler surveillance protocols. We assess ICI-induced cardiovascular toxicity and describe the rationale of the SIR-CVT.

Valor diagnóstico de la gammagrafía de perfusión miocárdica con 99mTc-Tetrofosmina en mujeres previamente revascularizadas / Diagnostic value of myocardial perfusion imaging with 99mTc-tetrofosmin in a population of women previously revascularized

Fundamento y objetivo: Se trata de un estudio transversal donde se han determinado los valores de sensibilidad y especificidad del estudio de perfusión miocárdica con 99mTc-Tetrofosmina en protocolo de un día tras estímulo farmacológico con dipiridamol, en una población de mujeres previamente revascularizadas, así como la relación con los territorios vasculares coronarios, tomando como referencia la coronariografía. Pacientes: Se han estudiado con carácter retrospectivo 53 historias clínicas de mujeres sometidas a una prueba de perfusión miocárdica y a una coronariografía de control. Resultados: Los valores de sensibilidad y especificidad para la población fueron de 64,29 por ciento y 75,0 por ciento respectivamente. Por territorio arterial coronario, los valores de sensibilidad y especificidad para la arteria DA fueron de 68,75 por ciento y 75,0 por ciento respectivamente, para la Cx de 37,93 por ciento y 88,89 por ciento, y para la CD de 46,43 por ciento y 60,71 por ciento. Conclusiones: En las mujeres que han sido previamente revascularizadas, la gammagrafía de perfusión miocárdica con 99mTc-Tetrofosmina y dipiridamol en protocolo de un día parece ser una prueba idónea para realizar el seguimiento de pacientes.

Background: This is a cross-sectional study to identify the values of sensitivity and specificity of myocardial perfusion imaging with 99mTc-tetrofosmin one-day protocol after pharmacological stimulation with dipyridamole in a population of women previously revascularized and the relationship of findings to coronary vascular territories, with coronary angiography as a gold standard. Patients We studied retrospectively 53 medical records of women undergoing myocardial perfusion test and control coronary angiography. Results: The sensitivity and specificity for the population were 64.29 percent and 75.0 percent respectively. For coronary artery territory, the values of sensitivity and specificity for the LAD were 68.75 percent and 75.0 percent respectively, for Cx of 37.93 percent and 88.89 percent, and for the RCA 46.43 percent and 60.71 percent. Conclusions: In women who have been previously revascularized, myocardial perfusion scintigraphy with 99mTc-tetrofosmin and dipyridamole in one-day protocol seems to be a suitable test to monitor patients.