title: Magnetic resonance imaging of the transplanted pediatric heart as a potential predictor of rejection.
abstract: OBJECTIVE
  To evaluate cardiac magnetic resonance imaging (CMR) as a non-invasive tool to detect acute cellular rejection (ACR) in children after heart transplant (HT).
  
  
  METHODS
  Thirty pediatric HT recipients underwent CMR at the time of surveillance endomyocardial biopsy (EMB) and results were compared to 14 non-transplant controls. Biventricular volumes, ejection fractions (EFs), T2-weighted signal intensities, native T1 times, extracellular volumes (ECVs) and presence of late gadolinium enhancement (LGE) were compared between patients and controls and between patients with International Society of Heart and Lung Transplantation (ISHLT) grade ≥ 2R rejection and those with grade 0/1R. Heart rate (HR) and brain natriuretic peptide (BNP) were assessed as potential biomarkers.
  
  
  RESULTS
  Significant ACR (ISHLT grade ≥ 2R) was an infrequent event in our population (5/30, 17%). Ventricular volumes, EFs, LGE prevalence, ECVs, native T1 times, T2 signal intensity ratios, HR and BNP were not associated with the presence of ≥ 2R ACR.
  
  
  CONCLUSIONS
  In this pilot study CMR did not reliably identify ACR-related changes in pediatric HT patients.
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Greenway
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Frederic
authors.initials: F
authors.lastname: Dallaire
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Kantor
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Anne I
authors.initials: AI
authors.lastname: Dipchand
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Rajiv R
authors.initials: RR
authors.lastname: Chaturvedi
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Monali
authors.initials: M
authors.lastname: Warade
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Eugenie
authors.initials: E
authors.lastname: Riesenkampff
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Shi-Joon
authors.initials: SJ
authors.lastname: Yoo
authors.affiliation: Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
authors.forename: Lars
authors.initials: L
authors.lastname: Grosse-Wortmann
keywords: Heart; Magnetic resonance imaging; Pediatric; Rejection; Transplantation