Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant
Background Surveillance for heart transplant rejection by endomyocardial biopsy is invasive and may yield false negatives. T1 and T2 mapping from cardiac magnetic resonance can demonstrate elevations with rejection. We sought to evaluate longitudinal changes in T1 and T2 mapping in pediatric patient...
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Wiley
2024-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.035798 |
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| author | Nicolle M. Ceneri Ravi Vegulla Nicholas Mouzakis Karin Hamann Devika Richmann Joshua Kanter John Berger Tacy Downing Yue‐Hin Loke Steven J. Staffa David Zurakowski Russell Cross Laura J. Olivieri |
| author_facet | Nicolle M. Ceneri Ravi Vegulla Nicholas Mouzakis Karin Hamann Devika Richmann Joshua Kanter John Berger Tacy Downing Yue‐Hin Loke Steven J. Staffa David Zurakowski Russell Cross Laura J. Olivieri |
| author_sort | Nicolle M. Ceneri |
| collection | DOAJ |
| description | Background Surveillance for heart transplant rejection by endomyocardial biopsy is invasive and may yield false negatives. T1 and T2 mapping from cardiac magnetic resonance can demonstrate elevations with rejection. We sought to evaluate longitudinal changes in T1 and T2 mapping in pediatric patients with heart transplant. Methods and Results A cohort study was performed of pediatric patients with heart transplant who underwent concurrent endomyocardial biopsy and cardiac magnetic resonance with T1 and T2 mapping from December 2019 to July 2024. Segmental values were measured and subsegmental elevations (ie, hotspots) were identified. Subjects were categorized as either treated rejection or no rejection. Peak and mean T1 and T2 values and number of hotspots at/between each time point for patient dyads were compared between the groups. A total of 21 subjects (7 treated rejection, 14 no rejection) with 68 total encounters met inclusion criteria. Peak and mean T1 values were higher in treated rejection patients during the rejection period and decreased with treatment (peak, 1086 versus 1052; mean, 1028 versus 1021), such that at last follow‐up when their rejection had resolved, there was no significant difference in values when compared with no rejection patients (peak, 1066; mean, 1016). The number of T1 hotspots decreased after rejection treatment (2 versus 1). There were no changes in peak or mean T2 values in the treated rejection group despite treatment, and peak and mean T2 values were similar to patients with no rejection through last follow‐up. Conclusions Elevated T1 values and hotspots observed during cardiac allograft rejection decline in response to treatment. Cardiac magnetic resonance may serve as a noninvasive monitoring tool for the development and resolution of rejection, as well as the effectiveness of rejection therapy. |
| format | Article |
| id | doaj-art-5d66d7516cbb498dba09db04bf7a1a21 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-5d66d7516cbb498dba09db04bf7a1a212025-08-20T02:48:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-11-01132110.1161/JAHA.124.035798Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart TransplantNicolle M. Ceneri0Ravi Vegulla1Nicholas Mouzakis2Karin Hamann3Devika Richmann4Joshua Kanter5John Berger6Tacy Downing7Yue‐Hin Loke8Steven J. Staffa9David Zurakowski10Russell Cross11Laura J. Olivieri12Children’s National Hospital Washington DCChildren’s National Hospital Washington DCChildren’s National Hospital Washington DCChildren’s National Hospital Washington DCColumbia University, Morgan Stanley Children’s Hospital New York NYChildren’s National Hospital Washington DCChildren’s National Hospital Washington DCChildren’s National Hospital Washington DCChildren’s National Hospital Washington DCDepartment of Anesthesiology and Surgery, Boston Children’s Hospital Harvard Medical School Boston MADepartment of Anesthesiology and Surgery, Boston Children’s Hospital Harvard Medical School Boston MANemours Children’s Hospital Wilmington DEUPMC Children’s Hospital of Pittsburgh Pittsburgh PABackground Surveillance for heart transplant rejection by endomyocardial biopsy is invasive and may yield false negatives. T1 and T2 mapping from cardiac magnetic resonance can demonstrate elevations with rejection. We sought to evaluate longitudinal changes in T1 and T2 mapping in pediatric patients with heart transplant. Methods and Results A cohort study was performed of pediatric patients with heart transplant who underwent concurrent endomyocardial biopsy and cardiac magnetic resonance with T1 and T2 mapping from December 2019 to July 2024. Segmental values were measured and subsegmental elevations (ie, hotspots) were identified. Subjects were categorized as either treated rejection or no rejection. Peak and mean T1 and T2 values and number of hotspots at/between each time point for patient dyads were compared between the groups. A total of 21 subjects (7 treated rejection, 14 no rejection) with 68 total encounters met inclusion criteria. Peak and mean T1 values were higher in treated rejection patients during the rejection period and decreased with treatment (peak, 1086 versus 1052; mean, 1028 versus 1021), such that at last follow‐up when their rejection had resolved, there was no significant difference in values when compared with no rejection patients (peak, 1066; mean, 1016). The number of T1 hotspots decreased after rejection treatment (2 versus 1). There were no changes in peak or mean T2 values in the treated rejection group despite treatment, and peak and mean T2 values were similar to patients with no rejection through last follow‐up. Conclusions Elevated T1 values and hotspots observed during cardiac allograft rejection decline in response to treatment. Cardiac magnetic resonance may serve as a noninvasive monitoring tool for the development and resolution of rejection, as well as the effectiveness of rejection therapy.https://www.ahajournals.org/doi/10.1161/JAHA.124.035798cardiac magnetic resonanceheart transplantparametric mappingpediatrics |
| spellingShingle | Nicolle M. Ceneri Ravi Vegulla Nicholas Mouzakis Karin Hamann Devika Richmann Joshua Kanter John Berger Tacy Downing Yue‐Hin Loke Steven J. Staffa David Zurakowski Russell Cross Laura J. Olivieri Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac magnetic resonance heart transplant parametric mapping pediatrics |
| title | Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant |
| title_full | Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant |
| title_fullStr | Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant |
| title_full_unstemmed | Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant |
| title_short | Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant |
| title_sort | longitudinal assessment of t1 mapping trends disease in pediatric patients with heart transplant |
| topic | cardiac magnetic resonance heart transplant parametric mapping pediatrics |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.035798 |
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