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May 16, 2026Journal of Cardiovascular Magnetic ResonanceOpen Access

Lower baseline CMR LVEF is linked to adverse cardiovascular outcomes in ICI myocarditis.

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Why the study?

Do baseline and serial CMR parameters correlate with adverse cardiovascular outcomes in patients with immune checkpoint inhibitor myocarditis?

Population

62 patients enrolled into two arms: 1) ICI myocarditis or 2) pre-ICI control.

Comparison

Serial Cardiovascular Magnetic Resonance imaging… vs Pre-ICI control cohort.

Design

Cohort

Follow-up

8-12 weeks (for follow-up CMR)

Key result

Decreased LVEF on baseline CMR imaging was associated with adverse cardiovascular outcomes in patients with immune checkpoint inhibitor myocarditis (r=-0.437, p=0.002).

Authors

JKJennifer M. KwanMKMohamad KhattabMTMaciej Tysarowski

Discussion

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Overview

Serial CMR parameters correlate with outcomes in ICI myocarditis; leaves open whether routine use refines risk stratification beyond biomarkers.

Key Points

  • The study aims to assess the changes in CMR parameters and their association with cardiovascular outcomes in ICI myocarditis.
  • Enrolled 62 patients into two cohorts: ICI myocarditis and pre-ICI control.
  • Performed CMR imaging at baseline and follow-up (8-12 weeks).
  • Evaluated associations between CMR parameters and adverse cardiovascular outcomes.
  • In the ICI myocarditis cohort, 38% had reduced left ventricular ejection fraction (LVEF < 57%), mean LVEF 58% (SD ±12).
  • 81% exhibited abnormal LV global longitudinal strain (mean GLS -10% SD ±5).
  • Decreased LVEF at enrollment significantly correlated with adverse cardiovascular events (ACE) (r=-0.437, p=0.002).

Study Design

Type

Cohort (n=62)

Structured PICO

Do baseline and serial CMR parameters correlate with adverse cardiovascular outcomes in patients with immune checkpoint inhibitor myocarditis?

P
Population
62 patients enrolled into two arms: 1) ICI myocarditis (ICI exposure with development of cardiac symptoms and abnormal cardiac biomarkers, N=52) or 2) pre-ICI control (patients planned to receive ICI therapy, N=10).
I
Intervention
Serial Cardiovascular Magnetic Resonance (CMR) imaging at the time of enrollment and upon follow up at 8-12 weeks.
C
Comparator
Pre-ICI control cohort (patients planned to receive ICI therapy).
O
Outcome
Adverse cardiovascular outcomes (ACE) associated with CMR parameters.composite

Main Result

Effect estimate: r=-0.437

p-value: p=0.002

Baseline and serial CMR parameters, including LVEF, global longitudinal strain, and left atrial strain, correlate with adverse cardiovascular outcomes in patients with immune checkpoint inhibitor myocarditis.

Cite This Study

Kwan et al. (2026) conducted a cohort in Immune checkpoint inhibitor (ICI) myocarditis (n=62). Serial Cardiovascular Magnetic Resonance (CMR) imaging vs. Pre-ICI control was evaluated on Adverse cardiovascular outcomes (ACE) (r=-0.437, p=0.002). Decreased LVEF on baseline CMR imaging was associated with adverse cardiovascular outcomes in patients with immune checkpoint inhibitor myocarditis (r=-0.437, p=0.002).

synapsesocial.com/papers/6a080ef2a487c87a6a40dafdhttps://doi.org/10.1016/j.jocmr.2026.102743
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