Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients
ABSTRACT: Background: Multiparametric cardiovascular magnetic resonance (CMR) has an emerging role in non-invasive surveillance of pediatric heart transplant recipients (PHTR). Higher myocardial T2, higher extracellular volume fraction (ECV), and late gadolinium enhancement (LGE) have been associat...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664724011657 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850214910956404736 |
|---|---|
| author | Andrew A. Lawson Kae Watanabe Lindsay Griffin Christina Laternser Michael Markl Cynthia K. Rigsby Joshua D. Robinson Nazia Husain |
| author_facet | Andrew A. Lawson Kae Watanabe Lindsay Griffin Christina Laternser Michael Markl Cynthia K. Rigsby Joshua D. Robinson Nazia Husain |
| author_sort | Andrew A. Lawson |
| collection | DOAJ |
| description | ABSTRACT: Background: Multiparametric cardiovascular magnetic resonance (CMR) has an emerging role in non-invasive surveillance of pediatric heart transplant recipients (PHTR). Higher myocardial T2, higher extracellular volume fraction (ECV), and late gadolinium enhancement (LGE) have been associated with adverse clinical outcomes in adult heart transplant recipients. The purpose of this study was to investigate the prognostic value of CMR-derived T1 and T2 mapping, ECV, and LGE for clinical outcomes in PHTR. Methods: We performed a single-center, retrospective chart review of consecutive, gadolinium-enhanced CMR studies in PHTR over a 7.5-year period, excluding follow-up studies. Standard CMR ventricular volume and function analysis, T1 mapping with ECV, T2 mapping, and LGE assessment were performed. The composite outcome included cardiac death, non-cardiac death, re-transplantation, and cardiac hospitalization. Results: Among 113 PHTR, mean age was 13.0 ± 5.1 years, with 6.0 ± 4.0 years since transplant. The indication for CMR was surveillance in 79%. Mean native T1 was 1050 ± 48 ms, T2 49.2 ± 3.9 ms, and ECV 29.7 ± 4.5%. Left ventricular LGE was present in 37% (42/113) and right ventricular LGE in 3.5% (4/113). The mean follow-up time was 2.3 years and median was 1.4 years. Cardiac death occurred in 2% (2/113), re-transplantation in 4% (4/113), and cardiac hospitalization in 22% (25/113). Non-cardiac death did not occur. Using Kaplan-Meier analysis, high T1 (≥1061 ms), T2 (≥50.0 ms), and ECV (≥31.4%) were each associated with decreased freedom from the composite outcome in follow-up. In univariable Cox regression analyses, high T1 was associated with increased risk of the composite outcome (hazard ratios [HR] 4.0, 95% confidence interval [CI] 1.7–9.2, p = 0.001), as were high T2 (HR 2.8, 95% CI 1.1–7.1, p = 0.026), and high ECV (HR 3.5, 95% CI 1.5–8.1, p = 0.004). Conclusion: T1 and T2 mapping are associated with early differences in adverse cardiac events in PHTR. These data suggest a role for a multicenter study with a longer follow-up duration. |
| format | Article |
| id | doaj-art-3a1133c39a4e428f8bbe657481e97694 |
| institution | OA Journals |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-3a1133c39a4e428f8bbe657481e976942025-08-20T02:08:46ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110113810.1016/j.jocmr.2024.101138Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipientsAndrew A. Lawson0Kae Watanabe1Lindsay Griffin2Christina Laternser3Michael Markl4Cynthia K. Rigsby5Joshua D. Robinson6Nazia Husain7Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Corresponding author.Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USADepartment of Radiology, Connecticut Children’s Medical Center, Hartford, Connecticut, USACenter for Cardiovascular Innovation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USADepartment of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USADepartment of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USADivision of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USADivision of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAABSTRACT: Background: Multiparametric cardiovascular magnetic resonance (CMR) has an emerging role in non-invasive surveillance of pediatric heart transplant recipients (PHTR). Higher myocardial T2, higher extracellular volume fraction (ECV), and late gadolinium enhancement (LGE) have been associated with adverse clinical outcomes in adult heart transplant recipients. The purpose of this study was to investigate the prognostic value of CMR-derived T1 and T2 mapping, ECV, and LGE for clinical outcomes in PHTR. Methods: We performed a single-center, retrospective chart review of consecutive, gadolinium-enhanced CMR studies in PHTR over a 7.5-year period, excluding follow-up studies. Standard CMR ventricular volume and function analysis, T1 mapping with ECV, T2 mapping, and LGE assessment were performed. The composite outcome included cardiac death, non-cardiac death, re-transplantation, and cardiac hospitalization. Results: Among 113 PHTR, mean age was 13.0 ± 5.1 years, with 6.0 ± 4.0 years since transplant. The indication for CMR was surveillance in 79%. Mean native T1 was 1050 ± 48 ms, T2 49.2 ± 3.9 ms, and ECV 29.7 ± 4.5%. Left ventricular LGE was present in 37% (42/113) and right ventricular LGE in 3.5% (4/113). The mean follow-up time was 2.3 years and median was 1.4 years. Cardiac death occurred in 2% (2/113), re-transplantation in 4% (4/113), and cardiac hospitalization in 22% (25/113). Non-cardiac death did not occur. Using Kaplan-Meier analysis, high T1 (≥1061 ms), T2 (≥50.0 ms), and ECV (≥31.4%) were each associated with decreased freedom from the composite outcome in follow-up. In univariable Cox regression analyses, high T1 was associated with increased risk of the composite outcome (hazard ratios [HR] 4.0, 95% confidence interval [CI] 1.7–9.2, p = 0.001), as were high T2 (HR 2.8, 95% CI 1.1–7.1, p = 0.026), and high ECV (HR 3.5, 95% CI 1.5–8.1, p = 0.004). Conclusion: T1 and T2 mapping are associated with early differences in adverse cardiac events in PHTR. These data suggest a role for a multicenter study with a longer follow-up duration.http://www.sciencedirect.com/science/article/pii/S1097664724011657Pediatric heart transplantT1 mappingT2 mappingExtracellular volume fractionLate gadolinium enhancementGraft surveillance |
| spellingShingle | Andrew A. Lawson Kae Watanabe Lindsay Griffin Christina Laternser Michael Markl Cynthia K. Rigsby Joshua D. Robinson Nazia Husain Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients Journal of Cardiovascular Magnetic Resonance Pediatric heart transplant T1 mapping T2 mapping Extracellular volume fraction Late gadolinium enhancement Graft surveillance |
| title | Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients |
| title_full | Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients |
| title_fullStr | Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients |
| title_full_unstemmed | Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients |
| title_short | Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients |
| title_sort | multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients |
| topic | Pediatric heart transplant T1 mapping T2 mapping Extracellular volume fraction Late gadolinium enhancement Graft surveillance |
| url | http://www.sciencedirect.com/science/article/pii/S1097664724011657 |
| work_keys_str_mv | AT andrewalawson multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT kaewatanabe multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT lindsaygriffin multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT christinalaternser multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT michaelmarkl multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT cynthiakrigsby multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT joshuadrobinson multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients AT naziahusain multiparametriccardiovascularmagneticresonanceisassociatedwithoutcomesinpediatrichearttransplantrecipients |