TY - JOUR
T1 - Diffuse myocardial fibrosis in children after heart transplantations
T2 - A magnetic resonance t1 mapping study
AU - Riesenkampff, Eugénie
AU - Chen, Ching Kit
AU - Kantor, Paul F.
AU - Greenway, Steven
AU - Chaturvedi, Rajiv R.
AU - Yoo, Shi Joon
AU - Greiser, Andreas
AU - Dipchand, Anne I.
AU - Grosse-Wortmann, Lars
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015
Y1 - 2015
N2 - 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). T1measurements were performed at amidventricular 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 myocardiumcompared 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.
AB - 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). T1measurements were performed at amidventricular 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 myocardiumcompared 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.
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U2 - 10.1097/TP.0000000000000769
DO - 10.1097/TP.0000000000000769
M3 - Article
C2 - 26102614
AN - SCOPUS:84952360798
SN - 0041-1337
VL - 99
SP - 2656
EP - 2662
JO - Transplantation
JF - Transplantation
IS - 12
ER -