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Contrast-enhanced mri patterns early and later after heart transplantation
Journal of Cardiovascular Magnetic Resonance volume 12, Article number: P162 (2010)
Introduction
In heart transplant (HTX) patients (pts.), contrast enhanced MRI (CE-MRI) allows myocardial tissue characterisation and identification of infarct- typical/-atypical C-MRI patterns which have prognostic implications. Recently it was shown that even pts. With mild transplant coronary artery disease (TCAD) on X-ray already suffered from myocardial infarction (MI) or fibrosis whereas scarce data exists about the time course of these events.
Purpose
We sought to investigate CE-MRI patterns in pts. early and late after HTX.
Methods
Group 1 (32 pts.;mean = 1,4 ys (range = 0.4-3.0 ys.) after HTX) and group 2 (31 pts.; mean = 8.8 ys (range = 3,4-16,8 ys) after HTX) were scanned on a 1.5 T MRI scanner (ACHIEVA, Philips, NL) with MRI contrast agent (Gadolinium:0.2 mmol/kg/bw) employing an inversion-recovery multislice T1-weighted TFE sequence (TR/TE = 3.0/1.1;slices = 11-22;matrix = 160/240, TF-factor = 35;TI190-250 ms). Infarct-typical CE-MRI areas were classified as sub-endocardial lesions. Infarct-atpyical forms were divided into diffuse, spotted, intramural and infero-septal CE-MRI patterns and analysed with the 17-segment model. Groups were compared using ANOVA (p-values ≤0.05 = statistically significant).
Results
Infarct-typical CE-MRI was already seen in 8/32 pts (25%) of group 1 (11/544 segments) and in 14/31 pts. (45%) of group 2 (26/527 segments;p < 0.01). Conversely, atypical CE-MRI was extensively seen in 26/32 pts (81%) of group 1 (165/544 segments) but only in 16/31 pts. (52%) of group 2 (40/527 segments;p < 0.01). Atypical CE-MRI forms of group 1 and 2 were statistically distributed equally (p = n.s.).
Conclusion
Even early after HTX already 25% of pts. suffered from MI whereas later after HTX almost half experienced an MI. In the early phase after HTX, atypical CE-MRI is by far more prevalent when compared to group 2, potentially due to disturbed integrity of the vasculature or due to infections or rejections. Once the early phase is overcome, long-term complications like MI will be more prevalent due to TCAD.
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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Steen, H., Lehrke, S., Lossnitzer, D. et al. Contrast-enhanced mri patterns early and later after heart transplantation. J Cardiovasc Magn Reson 12 (Suppl 1), P162 (2010). https://doi.org/10.1186/1532-429X-12-S1-P162
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DOI: https://doi.org/10.1186/1532-429X-12-S1-P162
Keywords
- Public Health
- Coronary Artery Disease
- Myocardial Infarction
- Contrast Agent
- Early Phase