Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Multiparametric Cardiac Magnetic Resonance Imaging Detects Altered Myocardial Tissue and Function in Heart Transplantation Recipients Monitored for Cardiac Allograft Vasculopathy

  • Muhannad A. Abbasi (Department of Radiology, Feinberg School of Medicine, Northwestern University) ;
  • Allison M. Blake (Department of Radiology, Feinberg School of Medicine, Northwestern University) ;
  • Roberto Sarnari (Department of Radiology, Feinberg School of Medicine, Northwestern University) ;
  • Daniel Lee (Department of Radiology, Feinberg School of Medicine, Northwestern University) ;
  • Allen S. Anderson (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • Kambiz Ghafourian (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • Sadiya S. Khan (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • Esther E. Vorovich (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • Jonathan D. Rich (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • Jane E. Wilcox (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • Clyde W. Yancy (Division of Cardiology, Department of Medicine, Northwestern University) ;
  • James C. Carr (Department of Radiology, Feinberg School of Medicine, Northwestern University) ;
  • Michael Markl (Department of Radiology, Feinberg School of Medicine, Northwestern University)
  • Received : 2022.01.05
  • Accepted : 2022.05.02
  • Published : 2022.10.27
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Abstract

BACKGROUND: Cardiac allograft vasculopathy (CAV) is a complication beyond the first-year post-heart transplantation (HTx). We aimed to test the utility of cardiac magnetic resonance (CMR) to detect functional/structural changes in HTx recipients with CAV. METHODS: Seventy-seven prospectively recruited HTx recipients beyond the first-year post-HTx and 18 healthy controls underwent CMR, including cine imaging of ventricular function and T1- and T2-mapping to assess myocardial tissue changes. Data analysis included quantification of global cardiac function and regional T2, T1 and extracellular volume based on the 16-segment model. International Society for Heart and Lung Transplantation criteria was used to adjudicate CAV grade (0-3) based on coronary angiography. RESULTS: The majority of HTx recipients (73%) presented with CAV (1: n = 42, 2/3: n = 14, 0: n = 21). Global and segmental T2 (49.5 ± 3.4 ms vs 50.6 ± 3.4 ms, p < 0.001;16/16 segments) were significantly elevated in CAV-0 compared to controls. When comparing CAV-2/3 to CAV-1, global and segmental T2 were significantly increased (53.6 ± 3.2 ms vs. 50.6 ± 2.9 ms, p < 0.001; 16/16 segments) and left ventricular ejection fraction was significantly decreased (54 ± 9% vs. 59 ± 9%, p < 0.05). No global, structural, or functional differences were seen between CAV-0 and CAV-1. CONCLUSIONS: Transplanted hearts display functional and structural alteration compared to native hearts, even in those without evidence of macrovasculopathy (CAV-0). In addition, CMR tissue parameters were sensitive to changes in CAV-1 vs. 2/3 (mild vs. moderate/severe). Further studies are warranted to evaluate the diagnostic value of CMR for the detection and classification of CAV.

Keywords

Acknowledgement

The work was supported by National Institutes of Health (National Heart, Lung, and Blood Institute [NHLBI] grant R01 HL117888).

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