Journal article
Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients
JACC. Cardiovascular imaging, Vol.13(7), pp.1521-1530
07/2020
DOI: 10.1016/j.jcmg.2020.01.014
PMCID: PMC8809107
PMID: 32199848
Abstract
The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients.
Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV] for assessment of interstitial expansion/fibrosis) are emerging modalities that have been investigated in various cardiomyopathies.
A total of 99 heart transplant patients underwent the magnetic resonance imaging (MRI) scans including T1- (n = 90) and T2-mapping (n = 79) techniques. Relevant clinical characteristics, MRI parameters including late gadolinium enhancement (LGE), and invasive hemodynamics were collected. Median clinical follow-up duration after the baseline scan was 2.4 to 3.5 years. Clinical outcomes include cardiac events (cardiac death, myocardial infarction, coronary revascularization, and heart failure hospitalization), noncardiac death and noncardiac hospitalization.
Overall, the global native T1, postcontrast T1, ECV, and T2 were 1,030 ± 56 ms, 458 ± 84 ms, 27 ± 4% and 50 ± 4 ms, respectively. Top-tercile-range ECV (ECV >29%) independently predicted adverse clinical outcomes compared with bottom-tercile-range ECV (ECV <25%) (hazard ratio [HR]: 2.87; 95% confidence interval [CI]: 1.07 to 7.68; p = 0.04) in a multivariable model with left ventricular end-systolic volume and LGE. Higher T2 (T2 ≥50.2 ms) independently predicted adverse clinical outcomes (HR: 3.01; 95% CI: 1.39 to 6.54; p = 0.005) after adjustment for left ventricular ejection fraction, left ventricular end-systolic volume, and LGE. Additionally, higher T2 (T2 ≥50.2 ms) also independently predicted cardiac events (HR: 4.92; CI: 1.60 to 15.14; p = 0.005) in a multivariable model with left ventricular ejection fraction.
MRI-derived myocardial ECV and T2 mapping in heart transplant patients were independently associated with cardiac and noncardiac outcomes. Our findings highlight the need for larger prospective studies.
[Display omitted]
Details
- Title: Subtitle
- Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients
- Creators
- Kongkiat Chaikriangkrai - Northwestern UniversityMuhannad Aboud Abbasi - Northwestern UniversityRoberto Sarnari - Northwestern UniversityRyan Dolan - Northwestern UniversityDaniel Lee - Northwestern UniversityAllen S. Anderson - Northwestern UniversityKambiz Ghafourian - Northwestern UniversitySadiya S. Khan - Northwestern UniversityEsther E. Vorovich - Northwestern UniversityJonathan D. Rich - Northwestern UniversityJane E. Wilcox - Northwestern UniversityJulie A. Blaisdell - Northwestern UniversityClyde W. Yancy - Northwestern UniversityJames Carr - Northwestern UniversityMichael Markl - Northwestern University
- Resource Type
- Journal article
- Publication Details
- JACC. Cardiovascular imaging, Vol.13(7), pp.1521-1530
- DOI
- 10.1016/j.jcmg.2020.01.014
- PMID
- 32199848
- PMCID
- PMC8809107
- NLM abbreviation
- JACC Cardiovasc Imaging
- ISSN
- 1936-878X
- eISSN
- 1876-7591
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 07/2020
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359935702771
Metrics
12 Record Views