title: Prevalence of different forms of infarct-atypical late gadolinium enhancement in patients early and late after heart transplantation.
abstract: BACKGROUND
  Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) enables high-resolution myocardial tissue characterization, showing the results of different injuries, especially in the early period after heart transplantation (HTX).
  
  
  OBJECTIVE
  We sought to apply LGE-CMR to investigate the prevalence and patterns of infarct-atypical myocardial involvement and associated mechanisms in patients early and late after HTX.
  
  
  METHODS
  LGE-CMR was performed on a 1.5-T MRI scanner (Philips, Best, the Netherlands) in 89 patients: group 1 (48 patients) less than 2.5 years after operation (1.2 ± 0.5 years) and group 2 (41 patients) later this period (8.2 ± 4.2 years). Following LGE-CMR, the presence, distribution, patterns of infarct-atypical LGE and possible associated mechanisms were assessed.
  
  
  RESULTS
  71 % of group 1 patients (34/48) showed infarctatypical LGE whereas 57 % of group 2 patients (22/41) were affected (p = 0.25). Fewer segments/patients were involved later after HTX (1.6 ± 2.0 vs. 2.9 ± 3.1 segments/ patient; p = 0.03), but only diffuse LGE-CMR pattern decreased significantly (11.5 % of affected segments in group 1 vs. 6.5 % in group 2; p\0.001). Group 2 had lower ischemic time (181 ± 53 vs. 208 ± 61 min; p = 0.03), the donors were younger (33 ± 13 vs. 41 ± 13 years; p = 0.01) and fewer donors were Toxoplasma gondii seropositive (4 vs. 22pts; p\0.001).
  
  
  CONCLUSIONS
  Infarct-atypical LGE was found in a significant number of patients early post-HTX, however, fewer patients and myocardial segments per patient were affected later after HTX. Many potential factors seem to be involved, but the exact mechanisms are still unclear. Future studies are necessary to test prognostic implications associated with LGE-CMR patterns.
authors.forename: M F
authors.initials: MF
authors.lastname: Braggion-Santos
authors.forename: F
authors.initials: F
authors.lastname: Andre
authors.forename: D
authors.initials: D
authors.lastname: Lossnitzer
authors.forename: E
authors.initials: E
authors.lastname: Hofmann
authors.forename: J
authors.initials: J
authors.lastname: Simpfendörfer
authors.forename: A
authors.initials: A
authors.lastname: Dösch
authors.forename: H A
authors.initials: HA
authors.lastname: Katus
authors.forename: H
authors.initials: H
authors.lastname: Steen
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D005858:Germany / Q000453:epidemiology; D006084:Graft Rejection / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA