Fig 1.
CMR showed normal LVEF (53%) with abnormal strain: A. peak global radial strain 36.4%, circumferential strain -19.7% and longitudinal strain −13.8%, B. graphical representation of peak global longitudinal strain and C. quantitative LGE of 7%.
Fig 2.
Sample quantitative late gadolinium enhancement.
Mid-myocardial LGE of the basal-to-mid inferoseptal wall and inferior right ventricular insertion site (A) and quantitative scar 8.4% (B).
Table 1.
Baseline patient characteristics.
Fig 3.
Time from starting Immune Checkpoint Inhibitor (ICI) to clinical presentation.
Fig 4.
Distribution of primary symptom on presentation (n = 20).
Fig 5.
Varying CMR presentations of Immune Checkpoint Inhibitor (ICI) associated cardiotoxicity.
Patient 1. Myocarditis with elevated T2-weighted signal (T2 ratio 2.2) (A) three chamber (B, white arrow) and short axis (C, white arrow) LGE imaging showing mid-myocardial LGE of basal inferior and inferoseptal walls. Patient 2. Acute myocardial infarction showing transmural LGE of the inferolateral wall with microvascular obstruction (D and E, white arrows) and corresponding increased signal on T2W-mapping (F, black arrow). Patient 3. Myopericarditis showing pericardial thickening and LGE on four chamber (G), short axis (H) and two chamber (I). Patient 4. Metastatic tumors within the basal inferior myocardium on two-chamber cine imaging (J, white arrow) with corresponding LGE (I, arrow) and edema on T2W imaging (J, black arrow).