Feasibility and safety of quantitative adenosine stress perfusion cardiac magnetic resonance imaging in pediatric heart transplant patients with and without coronary allograft vasculopathy
Background Pediatric heart transplant patients require cardiac catheterization to monitor for coronary allograft vasculopathy. Cardiac catheterization has no safe and consistent method for measuring microvascular disease. Stress perfusion cardiac magnetic resonance imaging (MRI) assessing microvascu...
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| Veröffentlicht in: | Pediatric radiology 2021-07, Vol.51 (8), p.1311-1321 |
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| container_title | Pediatric radiology |
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| creator | Duran, Silvestre R. Huffaker, Tyler Dixon, Bryant Gooty, Vasu Abou Zahr, Riad Arar, Yousef Greer, Joshua S. Butts, Ryan J. Hussain, Mohammad T. |
| description | Background
Pediatric heart transplant patients require cardiac catheterization to monitor for coronary allograft vasculopathy. Cardiac catheterization has no safe and consistent method for measuring microvascular disease. Stress perfusion cardiac magnetic resonance imaging (MRI) assessing microvascular disease has been performed in adults.
Objective
To investigate the feasibility and safety of performing cardiac MRI with quantitative adenosine stress perfusion testing in pediatric heart transplant patients with and without coronary allograft vasculopathy.
Materials and methods
All pediatric heart transplant patients with coronary vasculopathy at our institution were asked to participate. Age- and gender-matched pediatric heart transplant patients without vasculopathy were recruited for comparison. Patients underwent cardiac MRI with adenosine stress perfusion testing.
Results
Sixteen pediatric heart transplant patients, ages 6–22 years, underwent testing. Nine patients had vasculopathy by angiography. No heart block or other complications occurred during the study. The myocardial perfusion reserve for patients with vasculopathy showed no significant difference with comparison patients (median: 1.43 vs. 1.48;
P
=0.49). Values for both groups were lower than expected values based on previous adult studies. The patients were also analyzed for time after transplant and the number of rejection episodes. Patients within 6 years of transplantation had a nonsignificant trend toward a higher myocardial perfusion reserve (median: 1.57) versus patients with older transplants (median: 1.47;
P
=0.46). Intra- and interobserver reproducibility were 97% and 92%, respectively.
Conclusion
Myocardial perfusion reserve is a safe and feasible method for estimating myocardial perfusion in pediatric heart transplant patients. There is no reliable way to monitor microvascular disease in pediatric patients. This method shows potential and deserves investigation in a larger cohort. |
| doi_str_mv | 10.1007/s00247-021-04977-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2507733015</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2507733015</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-74375d7af1e033daa98a199b0d89a9946d5c5eda56f35a7c40a3303256cea8c83</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EotvCC3BAlrhwCYzjZB0fUdUCUiUucI5mncmuq6yd2k7RvlsfjtluAYkDJ4883__PaH4h3ij4oADMxwxQN6aCWlXQWGMq9UysVKPrSlnbPRcr0HBsNfZMnOd8CwC6VfqlONPaWNXpbiUergmz3_jJl4PEMMiMI3EZR3m3YCi-YPH3JHGgELMPJHNJlLOcKY1L9jFIh2nw6OQet4GKd5L7MWBwJD3_-bCVPjDPUEnc3hGmIkvCkOeJR8iZR1AoWf70Zfe4xLGIS5EuJnZKvNk0xW3Csch7zG6ZImt2h1fixYhTptdP74X4cX31_fJLdfPt89fLTzeV06YtlWn4GQyOikDrAdF2yBfawNBZtLZZD61racB2PeoWjWsAtQZdt2tH2LlOX4j3J985xbuFcun3PjuaeHuKS-7rFoxhiWoZffcPehuXFHg7phrbdABrYKo-US7FnBON_Zz4VunQK-iP2fanbHvOtn_MtlcsevtkvWz2NPyR_A6TAX0CMrfCltLf2f-x_QVWkLT-</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2549480060</pqid></control><display><type>article</type><title>Feasibility and safety of quantitative adenosine stress perfusion cardiac magnetic resonance imaging in pediatric heart transplant patients with and without coronary allograft vasculopathy</title><source>SpringerNature Journals</source><creator>Duran, Silvestre R. ; Huffaker, Tyler ; Dixon, Bryant ; Gooty, Vasu ; Abou Zahr, Riad ; Arar, Yousef ; Greer, Joshua S. ; Butts, Ryan J. ; Hussain, Mohammad T.</creator><creatorcontrib>Duran, Silvestre R. ; Huffaker, Tyler ; Dixon, Bryant ; Gooty, Vasu ; Abou Zahr, Riad ; Arar, Yousef ; Greer, Joshua S. ; Butts, Ryan J. ; Hussain, Mohammad T.</creatorcontrib><description>Background
Pediatric heart transplant patients require cardiac catheterization to monitor for coronary allograft vasculopathy. Cardiac catheterization has no safe and consistent method for measuring microvascular disease. Stress perfusion cardiac magnetic resonance imaging (MRI) assessing microvascular disease has been performed in adults.
Objective
To investigate the feasibility and safety of performing cardiac MRI with quantitative adenosine stress perfusion testing in pediatric heart transplant patients with and without coronary allograft vasculopathy.
Materials and methods
All pediatric heart transplant patients with coronary vasculopathy at our institution were asked to participate. Age- and gender-matched pediatric heart transplant patients without vasculopathy were recruited for comparison. Patients underwent cardiac MRI with adenosine stress perfusion testing.
Results
Sixteen pediatric heart transplant patients, ages 6–22 years, underwent testing. Nine patients had vasculopathy by angiography. No heart block or other complications occurred during the study. The myocardial perfusion reserve for patients with vasculopathy showed no significant difference with comparison patients (median: 1.43 vs. 1.48;
P
=0.49). Values for both groups were lower than expected values based on previous adult studies. The patients were also analyzed for time after transplant and the number of rejection episodes. Patients within 6 years of transplantation had a nonsignificant trend toward a higher myocardial perfusion reserve (median: 1.57) versus patients with older transplants (median: 1.47;
P
=0.46). Intra- and interobserver reproducibility were 97% and 92%, respectively.
Conclusion
Myocardial perfusion reserve is a safe and feasible method for estimating myocardial perfusion in pediatric heart transplant patients. There is no reliable way to monitor microvascular disease in pediatric patients. This method shows potential and deserves investigation in a larger cohort.</description><identifier>ISSN: 0301-0449</identifier><identifier>EISSN: 1432-1998</identifier><identifier>DOI: 10.1007/s00247-021-04977-1</identifier><identifier>PMID: 33791838</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adenosine ; Angiography ; Cardiac catheterization ; Catheterization ; Coronary artery disease ; Feasibility ; Graft rejection ; Heart transplantation ; Heart transplants ; Imaging ; Intubation ; Magnetic resonance imaging ; Measurement methods ; Medical imaging ; Medicine ; Medicine & Public Health ; Microvasculature ; Neuroradiology ; Nuclear Medicine ; Oncology ; Original Article ; Patients ; Pediatrics ; Perfusion ; Radiology ; Safety ; Transplantation ; Transplants ; Ultrasound ; Vascular diseases ; Vitamin C ; Vitamin E</subject><ispartof>Pediatric radiology, 2021-07, Vol.51 (8), p.1311-1321</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-74375d7af1e033daa98a199b0d89a9946d5c5eda56f35a7c40a3303256cea8c83</citedby><cites>FETCH-LOGICAL-c375t-74375d7af1e033daa98a199b0d89a9946d5c5eda56f35a7c40a3303256cea8c83</cites><orcidid>0000-0001-7238-7273</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00247-021-04977-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00247-021-04977-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33791838$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duran, Silvestre R.</creatorcontrib><creatorcontrib>Huffaker, Tyler</creatorcontrib><creatorcontrib>Dixon, Bryant</creatorcontrib><creatorcontrib>Gooty, Vasu</creatorcontrib><creatorcontrib>Abou Zahr, Riad</creatorcontrib><creatorcontrib>Arar, Yousef</creatorcontrib><creatorcontrib>Greer, Joshua S.</creatorcontrib><creatorcontrib>Butts, Ryan J.</creatorcontrib><creatorcontrib>Hussain, Mohammad T.</creatorcontrib><title>Feasibility and safety of quantitative adenosine stress perfusion cardiac magnetic resonance imaging in pediatric heart transplant patients with and without coronary allograft vasculopathy</title><title>Pediatric radiology</title><addtitle>Pediatr Radiol</addtitle><addtitle>Pediatr Radiol</addtitle><description>Background
Pediatric heart transplant patients require cardiac catheterization to monitor for coronary allograft vasculopathy. Cardiac catheterization has no safe and consistent method for measuring microvascular disease. Stress perfusion cardiac magnetic resonance imaging (MRI) assessing microvascular disease has been performed in adults.
Objective
To investigate the feasibility and safety of performing cardiac MRI with quantitative adenosine stress perfusion testing in pediatric heart transplant patients with and without coronary allograft vasculopathy.
Materials and methods
All pediatric heart transplant patients with coronary vasculopathy at our institution were asked to participate. Age- and gender-matched pediatric heart transplant patients without vasculopathy were recruited for comparison. Patients underwent cardiac MRI with adenosine stress perfusion testing.
Results
Sixteen pediatric heart transplant patients, ages 6–22 years, underwent testing. Nine patients had vasculopathy by angiography. No heart block or other complications occurred during the study. The myocardial perfusion reserve for patients with vasculopathy showed no significant difference with comparison patients (median: 1.43 vs. 1.48;
P
=0.49). Values for both groups were lower than expected values based on previous adult studies. The patients were also analyzed for time after transplant and the number of rejection episodes. Patients within 6 years of transplantation had a nonsignificant trend toward a higher myocardial perfusion reserve (median: 1.57) versus patients with older transplants (median: 1.47;
P
=0.46). Intra- and interobserver reproducibility were 97% and 92%, respectively.
Conclusion
Myocardial perfusion reserve is a safe and feasible method for estimating myocardial perfusion in pediatric heart transplant patients. There is no reliable way to monitor microvascular disease in pediatric patients. This method shows potential and deserves investigation in a larger cohort.</description><subject>Adenosine</subject><subject>Angiography</subject><subject>Cardiac catheterization</subject><subject>Catheterization</subject><subject>Coronary artery disease</subject><subject>Feasibility</subject><subject>Graft rejection</subject><subject>Heart transplantation</subject><subject>Heart transplants</subject><subject>Imaging</subject><subject>Intubation</subject><subject>Magnetic resonance imaging</subject><subject>Measurement methods</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microvasculature</subject><subject>Neuroradiology</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Perfusion</subject><subject>Radiology</subject><subject>Safety</subject><subject>Transplantation</subject><subject>Transplants</subject><subject>Ultrasound</subject><subject>Vascular diseases</subject><subject>Vitamin C</subject><subject>Vitamin E</subject><issn>0301-0449</issn><issn>1432-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kcFu1DAQhi0EotvCC3BAlrhwCYzjZB0fUdUCUiUucI5mncmuq6yd2k7RvlsfjtluAYkDJ4883__PaH4h3ij4oADMxwxQN6aCWlXQWGMq9UysVKPrSlnbPRcr0HBsNfZMnOd8CwC6VfqlONPaWNXpbiUergmz3_jJl4PEMMiMI3EZR3m3YCi-YPH3JHGgELMPJHNJlLOcKY1L9jFIh2nw6OQet4GKd5L7MWBwJD3_-bCVPjDPUEnc3hGmIkvCkOeJR8iZR1AoWf70Zfe4xLGIS5EuJnZKvNk0xW3Csch7zG6ZImt2h1fixYhTptdP74X4cX31_fJLdfPt89fLTzeV06YtlWn4GQyOikDrAdF2yBfawNBZtLZZD61racB2PeoWjWsAtQZdt2tH2LlOX4j3J985xbuFcun3PjuaeHuKS-7rFoxhiWoZffcPehuXFHg7phrbdABrYKo-US7FnBON_Zz4VunQK-iP2fanbHvOtn_MtlcsevtkvWz2NPyR_A6TAX0CMrfCltLf2f-x_QVWkLT-</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Duran, Silvestre R.</creator><creator>Huffaker, Tyler</creator><creator>Dixon, Bryant</creator><creator>Gooty, Vasu</creator><creator>Abou Zahr, Riad</creator><creator>Arar, Yousef</creator><creator>Greer, Joshua S.</creator><creator>Butts, Ryan J.</creator><creator>Hussain, Mohammad T.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7238-7273</orcidid></search><sort><creationdate>20210701</creationdate><title>Feasibility and safety of quantitative adenosine stress perfusion cardiac magnetic resonance imaging in pediatric heart transplant patients with and without coronary allograft vasculopathy</title><author>Duran, Silvestre R. ; Huffaker, Tyler ; Dixon, Bryant ; Gooty, Vasu ; Abou Zahr, Riad ; Arar, Yousef ; Greer, Joshua S. ; Butts, Ryan J. ; Hussain, Mohammad T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-74375d7af1e033daa98a199b0d89a9946d5c5eda56f35a7c40a3303256cea8c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adenosine</topic><topic>Angiography</topic><topic>Cardiac catheterization</topic><topic>Catheterization</topic><topic>Coronary artery disease</topic><topic>Feasibility</topic><topic>Graft rejection</topic><topic>Heart transplantation</topic><topic>Heart transplants</topic><topic>Imaging</topic><topic>Intubation</topic><topic>Magnetic resonance imaging</topic><topic>Measurement methods</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microvasculature</topic><topic>Neuroradiology</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Perfusion</topic><topic>Radiology</topic><topic>Safety</topic><topic>Transplantation</topic><topic>Transplants</topic><topic>Ultrasound</topic><topic>Vascular diseases</topic><topic>Vitamin C</topic><topic>Vitamin E</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duran, Silvestre R.</creatorcontrib><creatorcontrib>Huffaker, Tyler</creatorcontrib><creatorcontrib>Dixon, Bryant</creatorcontrib><creatorcontrib>Gooty, Vasu</creatorcontrib><creatorcontrib>Abou Zahr, Riad</creatorcontrib><creatorcontrib>Arar, Yousef</creatorcontrib><creatorcontrib>Greer, Joshua S.</creatorcontrib><creatorcontrib>Butts, Ryan 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duran, Silvestre R.</au><au>Huffaker, Tyler</au><au>Dixon, Bryant</au><au>Gooty, Vasu</au><au>Abou Zahr, Riad</au><au>Arar, Yousef</au><au>Greer, Joshua S.</au><au>Butts, Ryan J.</au><au>Hussain, Mohammad T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility and safety of quantitative adenosine stress perfusion cardiac magnetic resonance imaging in pediatric heart transplant patients with and without coronary allograft vasculopathy</atitle><jtitle>Pediatric radiology</jtitle><stitle>Pediatr Radiol</stitle><addtitle>Pediatr Radiol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>51</volume><issue>8</issue><spage>1311</spage><epage>1321</epage><pages>1311-1321</pages><issn>0301-0449</issn><eissn>1432-1998</eissn><abstract>Background
Pediatric heart transplant patients require cardiac catheterization to monitor for coronary allograft vasculopathy. Cardiac catheterization has no safe and consistent method for measuring microvascular disease. Stress perfusion cardiac magnetic resonance imaging (MRI) assessing microvascular disease has been performed in adults.
Objective
To investigate the feasibility and safety of performing cardiac MRI with quantitative adenosine stress perfusion testing in pediatric heart transplant patients with and without coronary allograft vasculopathy.
Materials and methods
All pediatric heart transplant patients with coronary vasculopathy at our institution were asked to participate. Age- and gender-matched pediatric heart transplant patients without vasculopathy were recruited for comparison. Patients underwent cardiac MRI with adenosine stress perfusion testing.
Results
Sixteen pediatric heart transplant patients, ages 6–22 years, underwent testing. Nine patients had vasculopathy by angiography. No heart block or other complications occurred during the study. The myocardial perfusion reserve for patients with vasculopathy showed no significant difference with comparison patients (median: 1.43 vs. 1.48;
P
=0.49). Values for both groups were lower than expected values based on previous adult studies. The patients were also analyzed for time after transplant and the number of rejection episodes. Patients within 6 years of transplantation had a nonsignificant trend toward a higher myocardial perfusion reserve (median: 1.57) versus patients with older transplants (median: 1.47;
P
=0.46). Intra- and interobserver reproducibility were 97% and 92%, respectively.
Conclusion
Myocardial perfusion reserve is a safe and feasible method for estimating myocardial perfusion in pediatric heart transplant patients. There is no reliable way to monitor microvascular disease in pediatric patients. This method shows potential and deserves investigation in a larger cohort.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33791838</pmid><doi>10.1007/s00247-021-04977-1</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-7238-7273</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Pediatric radiology, 2021-07, Vol.51 (8), p.1311-1321 |
| issn | 0301-0449 1432-1998 |
| language | eng |
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| source | SpringerNature Journals |
| subjects | Adenosine Angiography Cardiac catheterization Catheterization Coronary artery disease Feasibility Graft rejection Heart transplantation Heart transplants Imaging Intubation Magnetic resonance imaging Measurement methods Medical imaging Medicine Medicine & Public Health Microvasculature Neuroradiology Nuclear Medicine Oncology Original Article Patients Pediatrics Perfusion Radiology Safety Transplantation Transplants Ultrasound Vascular diseases Vitamin C Vitamin E |
| title | Feasibility and safety of quantitative adenosine stress perfusion cardiac magnetic resonance imaging in pediatric heart transplant patients with and without coronary allograft vasculopathy |
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