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57884 Fast strain-encoded cardiac magnetic resonance detects immune checkpoint inhibitor associated cardiotoxicity
- Jason Cuomo, Elio Ragheb, Attila Feher, Jennifer M. Kwan, Steffen Huber, Hamid Mojibian, Dana C. Peters, Albert Sinusas, Lauren A. Baldassarre
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- Journal:
- Journal of Clinical and Translational Science / Volume 5 / Issue s1 / March 2021
- Published online by Cambridge University Press:
- 30 March 2021, pp. 141-142
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- Article
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- Open access
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ABSTRACT IMPACT: Advanced cardiac magnetic resonance imaging techniques can help to protect cancer patients from cardiotoxicity from immunotherapy with a more sensitive assessment of cardiac function with strain imaging for detection of abnormal cardiac function in the setting of normal left ventricular ejection fraction. OBJECTIVES/GOALS: Immune checkpoint inhibitors (ICI) are associated with fatal cardiotoxicity. Cardiac magnetic resonance (CMR) imaging can assess ICI-associated cardiotoxicity, but the utility of CMR strain imaging is unknown. We present a study of patients with ICI-associated cardiotoxicity evaluated with fast strain-encoded (fast-SENC) CMR. METHODS/STUDY POPULATION: This prospective study was approved by the institutional IRB and informed consent was obtained from 15 patients (5 patients with ICI-associated cardiotoxicity, 10 controls patients) between August 2018 and January 2020. All patients with ICI-associated cardiotoxicity had abnormal troponin values and evidence of cardiotoxicity on T2-weighted and/or delayed enhancement CMR images. All patients underwent standard CMR assessment with steady state free precession cine images, T2-weighted imaging, and delayed gadolinium enhancement imaging. Additionally, free-breathing SENC images were obtained and then processed by a team of blinded cardiovascular imaging specialists using Myostrain software (Morrisville, USA). RESULTS/ANTICIPATED RESULTS: Left ventricular ejection fraction (LVEF) was normal in both groups (ï,³53%). Global longitudinal LV strain was significantly depressed in the ICI cardiotoxicity group versus controls (-12.8 ±3.2% vs. -16.6 ±1.9%, p=0.028). The average global circumferential LV strain was mildly abnormal (defined as strain > -17) in the ICI cardiotoxicity group and trended towards a higher value compared with controls (-16.0 ±2.6% vs -17.8 ±1.7%, p=0.103). The average number of dysfunctional segments (defined as strain > -10) was significantly higher in the ICI cardiotoxicity group (6.8 ±4.2 vs. 1.0 ±1.7, p=0.017). The proportion of abnormal myocardium was higher in the ICI cardiotoxicity group (66 ±21% vs. 45 ±18%, p=0.050), as well as the proportion of myocardium found to be dysfunctional (26 ±22% vs. 3.0 ±6.0%, p=0.041). DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite having preserved LVEF, patients who met criteria for ICI-associated cardiotoxicity had both global and regional abnormal LV strain. Fast-SENC imaging may provide a sensitive tool for detection of early cardiotoxicity in this population. This study is limited by its small cohort and a larger prospective study would be of value.
Idealism and Relativism in Ethics: Comparing China and Central Eastern Europe (CEE)
- from PART I - Society and Culture in Transition
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- By József Poór, Professor of Management in the Faculty of Economics and Social Sciences, Szent István University Hungary, Péter Fodor, University of Pécs, Hungary, Péter Kollár, Szent István University, Hungary, Attila Farkas, Szent István University, Hungary, János Fehér, Károli Gáspár University of the Reformed Church in Hungary, Patrick Woock, University of Science and Technology of China
- Edited by Joanna Wardęga
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- Book:
- China - Central and Eastern Europe Cross-Cultural Dialogue Society, Business and Education in Transition
- Published by:
- Jagiellonian University Press
- Published online:
- 22 December 2017
- Print publication:
- 01 September 2016, pp 13-34
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Summary
Introduction
The CEE region
Central and Eastern Europe (CEE) or Eastern and Central Europe are terms frequently used in science, politics and daily life alike. They are customarily used in connection with the part of Europe which differs in more significant respects – social, economic, cultural and political – from both Western and Eastern Europe. According to Halecki (1980), Europe is divided into four parts for historical reasons: Western Europe, West Central Europe, East Central Europe and Eastern Europe. CEE countries are situated geographically in the centre, one part lying within a bloc comprising Sweden, Germany and Italy, and the other between Russia and Turkey. Over the centuries, peoples of very diverse backgrounds have established their own independent states or even empires. In their relationships with Western and Eastern Europe they developed distinctive national cultures, and these have contributed greatly to the development of European civilization. The use of the term CEE as a definition in the political structure of the region strongly emphasizes that these states represent cultures different from those of Eastern Europe – more specifically, Russia (and, later, the Soviet Union) which ruled the whole territory after the Second World War. The anti-Soviet, anti-bolshevist argument can claim many serious protagonists, such as Bibó (1946) or Kundera (1984).
A single European culture is an abstract ideal, but this does not mean that it has no influence on the mentality of people. The sources of European culture are Greek philosophy, Roman law and monotheistic religions – in particular, Christianity – which are integrated into the traditional culture of various peoples. Progress and modernization took root and flourished in these. The most significant steps on the long journey towards modernization were the Renaissance, Humanism, the Reformation and the Enlightenment. According to various authors, the Enlightenment in particular can be considered as the great intellectual movement and historical era that helped establish modernity (Himmelfarb 2005; Israel 2002). The impact of the (ongoing) debate on the nature of science, world-view and the characteristics and consequences of individualistic secular morality is more profound. The basic difference between the CEE region and Eastern Europe is that such movements have more influence in CEE then in the East.