title: Late gadolinium enhancement in cardiac transplant patients is associated with adverse ventricular functional parameters and clinical outcomes.
abstract: BACKGROUND
  Heart transplant recipients (HTRs) experience multiple cardiac complications, many of which might produce myocardial fibrosis. Cardiovascular magnetic resonance imaging (CMR) can image myocardial fibrosis using late gadolinium enhancement (LGE) imaging. We hypothesized that the presence and volume of LGE in heart transplant recipients correlates with left ventricular (LV) functional parameters and clinical outcomes.
  
  
  METHODS
  Thirty-eight stable HTRs underwent a CMR study and clinical follow-up.
  
  
  RESULTS
  In 38 stable HTRs, LGE was seen in 19 patients (50%), of which 15 (79%) had a nonischemic pattern and 4 (21%) had an ischemic pattern. LGE volume was associated with reduced LV ejection fraction (EF) (R(2) = 0.57; P = 0.001) and increased LV end-diastolic volume (R(2) = 0.59; P = 0.001). The presence of LGE was associated with cardiovascular death or hospitalization within the next year (P = 0.04), and patients who died or were hospitalized had more LGE than those that were not hospitalized (15 g vs 7 g; P = 0.03).
  
  
  CONCLUSIONS
  LGE is common in HTR and is associated with adverse ventricular remodelling and adverse clinical outcomes. LGE might be a useful noninvasive approach to monitor graft disease in asymptomatic patients after heart transplant.
authors: Division of Cardiology, Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada. crbutler@ualberta.ca
authors: Craig R
authors: CR
authors: Butler
authors: Andreas
authors: A
authors: Kumar
authors: Mustafa
authors: M
authors: Toma
authors: Richard
authors: R
authors: Thompson
authors: Kelvin
authors: K
authors: Chow
authors: Debra
authors: D
authors: Isaac
authors: Daniel
authors: D
authors: Kim
authors: Mark
authors: M
authors: Haykowsky
authors: Matthias G
authors: MG
authors: Friedrich
authors: Ian
authors: I
authors: Paterson
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D003643:Death; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000009:adverse effects*; D016027:Heart Transplantation; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011183:Postoperative Complications; D011379:Prognosis; D013318:Stroke Volume / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000187:drug effects
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA