BACKGROUND: Following heart transplantation (Tx), recipients are closely monitored using endomyocardial biopsy, which is limited by cost and invasiveness, and echocardiography, which is limited regarding detailed structural and functional evaluation. PURPOSE: To test the feasibility of comprehensive structure-function cardiac MRI as a noninvasive modality to assess changes in myocardial structure and function. STUDY TYPE: Prospective. SUBJECTS: MR was performed in 61 heart transplant recipients (age 47.9 ± 16.3 years, 39% female) and 14 age-matched healthy controls (age 47.7 ± 16.7 years, 36% female). FIELD STRENGTH/SEQUENCE: 1.5T; 2D CINE steady state free precession (SSF)P imaging, T2 -mapping, pre- and postgadolinium contrast T1 -mapping, and tissue-phase mapping (TPM). ASSESSMENT: Quantification of myocardial T2 (as a measure of edema), pre- and post-Gd T1 (allowing calculation of extracellular volume (ECV) to estimate interstitial expansion), and TPM-based assessment of peak regional left ventricular (LV) velocities, dyssynchrony, and twist. STATISTICAL TESTS: Comparisons between transplant recipients and controls were performed using independent samples t-tests. Relationships between structural (T2 , T1 , ECV) and functional measures (myocardial velocities, dyssynchrony, twist) were assessed using Pearson correlation analysis. RESULTS: T2 and T1 were significantly elevated in transplant recipients compared to controls (global T2 : 50.5 ± 3.4 msec vs. 45.2 ± 2.3 msec, P < 0.01; global T1 : 1037.8 ± 48.0 msec vs. 993.8 ± 34.1 msec, P < 0.01). Systolic longitudinal function was impaired in transplant recipients compared to controls (reduced peak systolic longitudinal velocities, 2.9 ± 1.1 cm/s vs. 5.1 ± 1.2 cm/s, P < 0.01; elevated systolic longitudinal dyssynchrony, 60.2 ± 30.2 msec vs. 32.1 ± 25.1 msec, P < 0.01). Correlation analysis revealed a significant positive relationship between T2 and ECV (r = 0.45,P < 0.01). In addition, peak systolic longitudinal velocities demonstrated a significant inverse relationship with T2 (global r = -0.29, P = 0.02), and systolic radial dyssynchrony was positively associated with peak T2 and peak T1 (r = 0.26,P = 0.04; r = 0.27,P = 0.03). DATA CONCLUSION: MR techniques are sensitive to structural and functional differences in transplant recipients compared to controls. Structural (T2 , T1 ) and functional (peak myocardial velocities, dyssynchrony) measures were significantly associated, suggesting a structure-function relationship of cardiac abnormalities following heart transplant. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;49:678-687.
BACKGROUND: Following heart transplantation (Tx), recipients are closely monitored using endomyocardial biopsy, which is limited by cost and invasiveness, and echocardiography, which is limited regarding detailed structural and functional evaluation. PURPOSE: To test the feasibility of comprehensive structure-function cardiac MRI as a noninvasive modality to assess changes in myocardial structure and function. STUDY TYPE: Prospective. SUBJECTS: MR was performed in 61 heart transplant recipients (age 47.9 ± 16.3 years, 39% female) and 14 age-matched healthy controls (age 47.7 ± 16.7 years, 36% female). FIELD STRENGTH/SEQUENCE: 1.5T; 2D CINE steady state free precession (SSF)P imaging, T2 -mapping, pre- and postgadolinium contrast T1 -mapping, and tissue-phase mapping (TPM). ASSESSMENT: Quantification of myocardial T2 (as a measure of edema), pre- and post-Gd T1 (allowing calculation of extracellular volume (ECV) to estimate interstitial expansion), and TPM-based assessment of peak regional left ventricular (LV) velocities, dyssynchrony, and twist. STATISTICAL TESTS: Comparisons between transplant recipients and controls were performed using independent samples t-tests. Relationships between structural (T2 , T1 , ECV) and functional measures (myocardial velocities, dyssynchrony, twist) were assessed using Pearson correlation analysis. RESULTS: T2 and T1 were significantly elevated in transplant recipients compared to controls (global T2 : 50.5 ± 3.4 msec vs. 45.2 ± 2.3 msec, P < 0.01; global T1 : 1037.8 ± 48.0 msec vs. 993.8 ± 34.1 msec, P < 0.01). Systolic longitudinal function was impaired in transplant recipients compared to controls (reduced peak systolic longitudinal velocities, 2.9 ± 1.1 cm/s vs. 5.1 ± 1.2 cm/s, P < 0.01; elevated systolic longitudinal dyssynchrony, 60.2 ± 30.2 msec vs. 32.1 ± 25.1 msec, P < 0.01). Correlation analysis revealed a significant positive relationship between T2 and ECV (r = 0.45,P < 0.01). In addition, peak systolic longitudinal velocities demonstrated a significant inverse relationship with T2 (global r = -0.29, P = 0.02), and systolic radial dyssynchrony was positively associated with peak T2 and peak T1 (r = 0.26,P = 0.04; r = 0.27,P = 0.03). DATA CONCLUSION: MR techniques are sensitive to structural and functional differences in transplant recipients compared to controls. Structural (T2 , T1 ) and functional (peak myocardial velocities, dyssynchrony) measures were significantly associated, suggesting a structure-function relationship of cardiac abnormalities following heart transplant. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;49:678-687.
Authors: P Y Marie; M Angioï; J P Carteaux; J M Escanye; S Mattei; K Tzvetanov; O Claudon; N Hassan; N Danchin; G Karcher; A Bertrand; P M Walker; J P Villemot Journal: J Am Coll Cardiol Date: 2001-03-01 Impact factor: 24.094
Authors: Lars H Lund; Leah B Edwards; Anne I Dipchand; Samuel Goldfarb; Anna Y Kucheryavaya; Bronwyn J Levvey; Bruno Meiser; Joseph W Rossano; Roger D Yusen; Josef Stehlik Journal: J Heart Lung Transplant Date: 2016-08-21 Impact factor: 10.247
Authors: Boaz D Rosen; Veronica R S Fernandes; Khuram Nasir; Thomas Helle-Valle; Michael Jerosch-Herold; David A Bluemke; Joao A C Lima Journal: Circulation Date: 2009-08-24 Impact factor: 29.690
Authors: Christopher A Miller; Jaydeep Sarma; Josephine H Naish; Nizar Yonan; Simon G Williams; Steven M Shaw; David Clark; Keith Pearce; Martin Stout; Rahul Potluri; Alex Borg; Glyn Coutts; Saqib Chowdhary; Gerry P McCann; Geoffrey J M Parker; Simon G Ray; Matthias Schmitt Journal: J Am Coll Cardiol Date: 2013-12-18 Impact factor: 24.094
Authors: Steffen E Petersen; Nay Aung; Mihir M Sanghvi; Filip Zemrak; Kenneth Fung; Jose Miguel Paiva; Jane M Francis; Mohammed Y Khanji; Elena Lukaschuk; Aaron M Lee; Valentina Carapella; Young Jin Kim; Paul Leeson; Stefan K Piechnik; Stefan Neubauer Journal: J Cardiovasc Magn Reson Date: 2017-02-03 Impact factor: 5.364
Authors: Craig R Butler; Richard Thompson; Mark Haykowsky; Mustafa Toma; Ian Paterson Journal: J Cardiovasc Magn Reson Date: 2009-03-12 Impact factor: 5.364
Authors: Alexander Ruh; Roberto Sarnari; Haben Berhane; Kenny Sidoryk; Kai Lin; Ryan Dolan; Arleen Li; Michael J Rose; Joshua D Robinson; James C Carr; Cynthia K Rigsby; Michael Markl Journal: Int J Cardiovasc Imaging Date: 2019-02-04 Impact factor: 2.357
Authors: Christopher A Hanson; Akshay Kamath; Matthew Gottbrecht; Sami Ibrahim; Michael Salerno Journal: Radiology Date: 2020-08-25 Impact factor: 11.105
Authors: Haben Berhane; Alexander Ruh; Nazia Husain; Joshua D Robinson; Cynthia K Rigsby; Michael Markl Journal: J Magn Reson Imaging Date: 2019-09-12 Impact factor: 4.813
Authors: Ryan S Dolan; Amir A Rahsepar; Julie Blaisdell; Roberto Sarnari; Kambiz Ghafourian; Jane E Wilcox; Sadiya S Khan; Esther E Vorovich; Jonathan D Rich; Clyde W Yancy; Allen S Anderson; James C Carr; Michael Markl Journal: Radiol Cardiothorac Imaging Date: 2019-12-19
Authors: Kongkiat Chaikriangkrai; Muhannad Aboud Abbasi; Roberto Sarnari; Ryan Dolan; Daniel Lee; Allen S Anderson; Kambiz Ghafourian; Sadiya S Khan; Esther E Vorovich; Jonathan D Rich; Jane E Wilcox; Julie A Blaisdell; Clyde W Yancy; James Carr; Michael Markl Journal: JACC Cardiovasc Imaging Date: 2020-03-18
Authors: G J H Snel; M van den Boomen; L M Hernandez; C T Nguyen; D E Sosnovik; B K Velthuis; R H J A Slart; R J H Borra; N H J Prakken Journal: J Cardiovasc Magn Reson Date: 2020-05-11 Impact factor: 5.364