Diffuse Myocardial Fibrosis in Children After Heart Transplantations: A Magnetic Resonance T1 Mapping Study. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: Riesenkampff, Eugénie; Chen, Ching Kit; Kantor, Paul F.; Greenway, Steven; Chaturvedi, Rajiv R.; Yoo, Shi-Joon; Greiser, Andreas; Dipchand, Anne I.; Grosse-Wortmann, Lars
• Is Part Of: Transplantation. Volume 99:Issue 12(2015)
• Publication Date: 2015-12
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000769
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: It is unclear whether the myocardium undergoes accelerated fibrotic remodeling in children after heart transplantation (HTx). Methods: In this prospective study, cardiac magnetic resonance (CMR) studies in 17 patients 1.3 years (median, range 0.03-12.6 years) after HTx (mean age, 9.8 ± 6.2 years; 8 girls) were compared to CMR studies in 9 healthy controls (mean age, 12.4 ± 2.4 years; 4 girls). T1 measurements were performed at a midventricular short axis slice before (ie, native T1 times) and after the application of 0.2 mmol/kg gadopentetate dimeglumine in the interventricular septum, left ventricular (LV) free wall and encompassing the entire LV myocardium. The tissue-blood partition coefficient (TBPC), reflecting the degree of diffuse myocardial fibrosis, was calculated as a function of the ratio of T1 change of myocardium compared to blood. Native T1 times and TBPC were correlated with echocardiographic parameters of diastolic function. Results: Native T1 times were significantly higher in HTx patients compared to controls in all regions assessed (LV free wall 973 ± 42 vs 923 ± 12 ms; P < 0.005; interventricular septum 1003 ± 31 vs 974 ± 21 ms, P < 0.05; entire LV myocardium 987 ± 33 vs 951 ± 16 ms; P < 0.005) and correlated with LV E/e' as an echocardiographic marker of diastolic dysfunction (r = 0.54, P < 0.05). The TBPC was elevated in the LV free wall (0.45 ± 0.06 vs 0.40 ± 0.03, P < 0.005) and the entire LV myocardium (0.47 ± 0.06 vs 0.43 ± 0.03, P < 0.05). Conclusions: Evidence of diffuse myocardial fibrosis and is already present in children after HTx. It appears to be associated with diastolic dysfunction. Abstract : The authors used noninvasive cardiovascular magnetic resonance in 17 pediatric heart transplant recipients to document that compared to 9 healthy controls there is early and increased diffuse myocardial fibrosis after heart transplant that correlates with echocardiographic evidence of diastolic dysfunction.