title: Magnetic resonance assessment of left ventricular diastolic dysfunction for detecting cardiac allograft vasculopathy in recipients of heart transplants.
abstract: Cardiac allograft vasculopathy (CAV) is a major late complication in heart transplant recipients, graded based on intravascular ultrasound (IVUS), and accelerates left ventricular (LV) diastolic dysfunction. We investigated the clinical feasibility of using magnetic resonance (MR) to assess LV diastolic dysfunction noninvasively in transplant recipients. Thirty-eight asymptomatic recipients (25 men, 37.2 ± 14.9 years) underwent both IVUS and cardiac MR. Based on IVUS, we divided the individuals into 2 groups using Stanford classification to categorize CAV development as either nonsignificant or advanced. We measured LV peak filling rate (PFR) and systolic function parameters, including LV ejection fraction (EF), stroke volume (SV), and cardiac output (CO) using cine MR; compared those values between groups; calculated receiver operating characteristic curve in the relationship between PFR value and CAV; and assessed myocardial late gadolinium enhancement (LGE) on contrast-enhanced MR. We classified CAV as advanced in 20 patients (53%) and nonsignificant in 18 (47%). LV EF, SV, and CO values were not significantly different. PFR was significantly lower in the advanced (3.63 ± 0.90 EDV/s) than nonsignificant group (4.43 ± 0.84 EDV/s, P = 0.01). The area under the curve was 0.76. We observed no myocardial LGE. MR measurement of PFR may permit noninvasive assessment of diastolic dysfunction associated with CAV before LV systolic dysfunction and myocardial infarction or scar formation develop.
authors: Department of Radiology, Medical Center East, Tokyo Women's Medical University, 2-1-10 Nishiogu, Arakawa-ku, Tokyo 116-8567, Japan. machira@dnh.twmu.ac.jp
authors: Haruhiko
authors: H
authors: Machida
authors: Shinichi
authors: S
authors: Nunoda
authors: Kiyotaka
authors: K
authors: Okajima
authors: Kazunobu
authors: K
authors: Shitakura
authors: Akihiko
authors: A
authors: Sekikawa
authors: Yutaka
authors: Y
authors: Kubo
authors: Kuniaki
authors: K
authors: Otsuka
authors: Masami
authors: M
authors: Hirata
authors: Shinya
authors: S
authors: Kojima
authors: Eiko
authors: E
authors: Ueno
mesh_terms: D000328:Adult; D000367:Age Factors; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007564:Japan; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D055815:Young Adult
chemical_list: D003287:Contrast Media