CT derived myocardial extracellular volume predict major adverse cardiovascular events in patients with prostate cancer.

[BACKGROUND] Prostate cancer (PCa) patients with androgen deprivation therapy (ADT) are at high risk for cardiotoxicity and major adverse cardiovascular events (MACE). It is unclear whether the myocardial extracellular volume (ECV) derived from chest contrast-enhanced CT (CECT) can detect cardiotoxicity and predict MACE in these patients. This work aimed to assess the value of chest CECT derived myocardial ECV for detecting cardiotoxicity and the association of ECV with MACE in PCa patients receiving ADT.

[METHODS] PCa patients with ADT between December 1, 2014 and March 31, 2020 were retrospectively included. Chest CECT derived myocardial ECV was obtained before ADT and approximately 3, 6, 9, and 12 months after ADT initiation. The differences in myocardial ECV between the MACE (+) and MACE (-) groups were analyzed by Student's t-test, and the association between myocardial ECV and MACE was analyzed using a Cox proportional hazards model.

[RESULTS] In total, 180 patients were included, of whom 44 patients developed MACE. Myocardial ECV was significantly higher after 3 months of ADT than at baseline and peaked after 12 months of ADT. Moreover, the myocardial ECV of the MACE (+) group was higher than that of the MACE (-) group at each follow-up visit. A higher ECV at 3, 6, and 9 months after ADT was associated with an increased risk for MACE (adjusted hazard ratios were 2.695, 3.670, and 4.450, respectively).

[CONCLUSION] Myocardial ECV derived from chest CECT can be used to dynamically monitor cardiotoxicity and predict MACE in patients with PCa receiving ADT.