Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients
The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients. Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV...
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| Veröffentlicht in: | JACC. Cardiovascular imaging 2020-07, Vol.13 (7), p.1521-1530 |
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| creator | Chaikriangkrai, Kongkiat Abbasi, Muhannad Aboud Sarnari, Roberto Dolan, Ryan Lee, Daniel Anderson, Allen S. Ghafourian, Kambiz Khan, Sadiya S. Vorovich, Esther E. Rich, Jonathan D. Wilcox, Jane E. Blaisdell, Julie A. Yancy, Clyde W. Carr, James Markl, Michael |
| description | The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients.
Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV] for assessment of interstitial expansion/fibrosis) are emerging modalities that have been investigated in various cardiomyopathies.
A total of 99 heart transplant patients underwent the magnetic resonance imaging (MRI) scans including T1- (n = 90) and T2-mapping (n = 79) techniques. Relevant clinical characteristics, MRI parameters including late gadolinium enhancement (LGE), and invasive hemodynamics were collected. Median clinical follow-up duration after the baseline scan was 2.4 to 3.5 years. Clinical outcomes include cardiac events (cardiac death, myocardial infarction, coronary revascularization, and heart failure hospitalization), noncardiac death and noncardiac hospitalization.
Overall, the global native T1, postcontrast T1, ECV, and T2 were 1,030 ± 56 ms, 458 ± 84 ms, 27 ± 4% and 50 ± 4 ms, respectively. Top-tercile-range ECV (ECV >29%) independently predicted adverse clinical outcomes compared with bottom-tercile-range ECV (ECV |
| doi_str_mv | 10.1016/j.jcmg.2020.01.014 |
| format | Article |
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Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV] for assessment of interstitial expansion/fibrosis) are emerging modalities that have been investigated in various cardiomyopathies.
A total of 99 heart transplant patients underwent the magnetic resonance imaging (MRI) scans including T1- (n = 90) and T2-mapping (n = 79) techniques. Relevant clinical characteristics, MRI parameters including late gadolinium enhancement (LGE), and invasive hemodynamics were collected. Median clinical follow-up duration after the baseline scan was 2.4 to 3.5 years. Clinical outcomes include cardiac events (cardiac death, myocardial infarction, coronary revascularization, and heart failure hospitalization), noncardiac death and noncardiac hospitalization.
Overall, the global native T1, postcontrast T1, ECV, and T2 were 1,030 ± 56 ms, 458 ± 84 ms, 27 ± 4% and 50 ± 4 ms, respectively. Top-tercile-range ECV (ECV >29%) independently predicted adverse clinical outcomes compared with bottom-tercile-range ECV (ECV <25%) (hazard ratio [HR]: 2.87; 95% confidence interval [CI]: 1.07 to 7.68; p = 0.04) in a multivariable model with left ventricular end-systolic volume and LGE. Higher T2 (T2 ≥50.2 ms) independently predicted adverse clinical outcomes (HR: 3.01; 95% CI: 1.39 to 6.54; p = 0.005) after adjustment for left ventricular ejection fraction, left ventricular end-systolic volume, and LGE. Additionally, higher T2 (T2 ≥50.2 ms) also independently predicted cardiac events (HR: 4.92; CI: 1.60 to 15.14; p = 0.005) in a multivariable model with left ventricular ejection fraction.
MRI-derived myocardial ECV and T2 mapping in heart transplant patients were independently associated with cardiac and noncardiac outcomes. Our findings highlight the need for larger prospective studies.
[Display omitted]</description><identifier>ISSN: 1936-878X</identifier><identifier>EISSN: 1876-7591</identifier><identifier>DOI: 10.1016/j.jcmg.2020.01.014</identifier><identifier>PMID: 32199848</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Contrast Media ; extracellular volume fraction ; Fibrosis ; Gadolinium ; Heart Transplantation ; Humans ; magnetic resonance imaging ; Magnetic Resonance Imaging, Cine ; Myocardium - pathology ; natural history ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Stroke Volume ; T1 mapping ; T2 mapping ; Ventricular Function, Left</subject><ispartof>JACC. Cardiovascular imaging, 2020-07, Vol.13 (7), p.1521-1530</ispartof><rights>2020 American College of Cardiology Foundation</rights><rights>Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-a65bf3e20eb985053c00f8f9f00da201b26f7cf27b83eebe3d22339ddef691043</citedby><cites>FETCH-LOGICAL-c455t-a65bf3e20eb985053c00f8f9f00da201b26f7cf27b83eebe3d22339ddef691043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcmg.2020.01.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32199848$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chaikriangkrai, Kongkiat</creatorcontrib><creatorcontrib>Abbasi, Muhannad Aboud</creatorcontrib><creatorcontrib>Sarnari, Roberto</creatorcontrib><creatorcontrib>Dolan, Ryan</creatorcontrib><creatorcontrib>Lee, Daniel</creatorcontrib><creatorcontrib>Anderson, Allen S.</creatorcontrib><creatorcontrib>Ghafourian, Kambiz</creatorcontrib><creatorcontrib>Khan, Sadiya S.</creatorcontrib><creatorcontrib>Vorovich, Esther E.</creatorcontrib><creatorcontrib>Rich, Jonathan D.</creatorcontrib><creatorcontrib>Wilcox, Jane E.</creatorcontrib><creatorcontrib>Blaisdell, Julie A.</creatorcontrib><creatorcontrib>Yancy, Clyde W.</creatorcontrib><creatorcontrib>Carr, James</creatorcontrib><creatorcontrib>Markl, Michael</creatorcontrib><title>Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients</title><title>JACC. Cardiovascular imaging</title><addtitle>JACC Cardiovasc Imaging</addtitle><description>The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients.
Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV] for assessment of interstitial expansion/fibrosis) are emerging modalities that have been investigated in various cardiomyopathies.
A total of 99 heart transplant patients underwent the magnetic resonance imaging (MRI) scans including T1- (n = 90) and T2-mapping (n = 79) techniques. Relevant clinical characteristics, MRI parameters including late gadolinium enhancement (LGE), and invasive hemodynamics were collected. Median clinical follow-up duration after the baseline scan was 2.4 to 3.5 years. Clinical outcomes include cardiac events (cardiac death, myocardial infarction, coronary revascularization, and heart failure hospitalization), noncardiac death and noncardiac hospitalization.
Overall, the global native T1, postcontrast T1, ECV, and T2 were 1,030 ± 56 ms, 458 ± 84 ms, 27 ± 4% and 50 ± 4 ms, respectively. Top-tercile-range ECV (ECV >29%) independently predicted adverse clinical outcomes compared with bottom-tercile-range ECV (ECV <25%) (hazard ratio [HR]: 2.87; 95% confidence interval [CI]: 1.07 to 7.68; p = 0.04) in a multivariable model with left ventricular end-systolic volume and LGE. Higher T2 (T2 ≥50.2 ms) independently predicted adverse clinical outcomes (HR: 3.01; 95% CI: 1.39 to 6.54; p = 0.005) after adjustment for left ventricular ejection fraction, left ventricular end-systolic volume, and LGE. Additionally, higher T2 (T2 ≥50.2 ms) also independently predicted cardiac events (HR: 4.92; CI: 1.60 to 15.14; p = 0.005) in a multivariable model with left ventricular ejection fraction.
MRI-derived myocardial ECV and T2 mapping in heart transplant patients were independently associated with cardiac and noncardiac outcomes. Our findings highlight the need for larger prospective studies.
[Display omitted]</description><subject>Contrast Media</subject><subject>extracellular volume fraction</subject><subject>Fibrosis</subject><subject>Gadolinium</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Myocardium - pathology</subject><subject>natural history</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Stroke Volume</subject><subject>T1 mapping</subject><subject>T2 mapping</subject><subject>Ventricular Function, Left</subject><issn>1936-878X</issn><issn>1876-7591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV1rFTEQhhdR7If-AS8kl97scZLsRxZEkNLaQsVeHIt3IZudnOawm6xJtrT_3iynFr0RBhImb54Z3rco3lHYUKDNx_1mr6fdhgGDDdBc1YvimIq2Kdu6oy_zveNNKVrx86g4iXEP0EBTta-LI85o14lKHBd3N8HvnI_JanKrxgWJN-Tbo9cqDFaN5PwhBaVxHJdRBXLrx2VCcpFbyXpHlBvIlpWTmmfrdsQ6cokqJLINysV5VC6RG5UsuhTfFK-MGiO-fTpPix8X59uzy_L6-9ersy_Xpa7qOpWqqXvDkQH2naih5hrACNMZgEExoD1rTKsNa3vBEXvkA2Ocd8OApukoVPy0-Hzgzks_4aDz7KBGOQc7qfAovbLy3xdn7-TO30shIAPaDPjwBAj-14IxycnG1QHl0C9RMi5otq5r6ixlB6kOPsaA5nkMBblGJPdyjUiuEUmgudYF3_-94POXP5lkwaeDALNN9xaDjDpbqHGwAXWSg7f_4_8GESSlMA</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Chaikriangkrai, Kongkiat</creator><creator>Abbasi, Muhannad Aboud</creator><creator>Sarnari, Roberto</creator><creator>Dolan, Ryan</creator><creator>Lee, Daniel</creator><creator>Anderson, Allen S.</creator><creator>Ghafourian, Kambiz</creator><creator>Khan, Sadiya S.</creator><creator>Vorovich, Esther E.</creator><creator>Rich, Jonathan D.</creator><creator>Wilcox, Jane E.</creator><creator>Blaisdell, Julie A.</creator><creator>Yancy, Clyde W.</creator><creator>Carr, James</creator><creator>Markl, Michael</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200701</creationdate><title>Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients</title><author>Chaikriangkrai, Kongkiat ; Abbasi, Muhannad Aboud ; Sarnari, Roberto ; Dolan, Ryan ; Lee, Daniel ; Anderson, Allen S. ; Ghafourian, Kambiz ; Khan, Sadiya S. ; Vorovich, Esther E. ; Rich, Jonathan D. ; Wilcox, Jane E. ; Blaisdell, Julie A. ; Yancy, Clyde W. ; Carr, James ; Markl, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-a65bf3e20eb985053c00f8f9f00da201b26f7cf27b83eebe3d22339ddef691043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Contrast Media</topic><topic>extracellular volume fraction</topic><topic>Fibrosis</topic><topic>Gadolinium</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Cine</topic><topic>Myocardium - pathology</topic><topic>natural history</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Stroke Volume</topic><topic>T1 mapping</topic><topic>T2 mapping</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chaikriangkrai, Kongkiat</creatorcontrib><creatorcontrib>Abbasi, Muhannad Aboud</creatorcontrib><creatorcontrib>Sarnari, Roberto</creatorcontrib><creatorcontrib>Dolan, Ryan</creatorcontrib><creatorcontrib>Lee, Daniel</creatorcontrib><creatorcontrib>Anderson, Allen S.</creatorcontrib><creatorcontrib>Ghafourian, Kambiz</creatorcontrib><creatorcontrib>Khan, Sadiya S.</creatorcontrib><creatorcontrib>Vorovich, Esther E.</creatorcontrib><creatorcontrib>Rich, Jonathan D.</creatorcontrib><creatorcontrib>Wilcox, Jane E.</creatorcontrib><creatorcontrib>Blaisdell, Julie A.</creatorcontrib><creatorcontrib>Yancy, Clyde W.</creatorcontrib><creatorcontrib>Carr, James</creatorcontrib><creatorcontrib>Markl, Michael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JACC. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chaikriangkrai, Kongkiat</au><au>Abbasi, Muhannad Aboud</au><au>Sarnari, Roberto</au><au>Dolan, Ryan</au><au>Lee, Daniel</au><au>Anderson, Allen S.</au><au>Ghafourian, Kambiz</au><au>Khan, Sadiya S.</au><au>Vorovich, Esther E.</au><au>Rich, Jonathan D.</au><au>Wilcox, Jane E.</au><au>Blaisdell, Julie A.</au><au>Yancy, Clyde W.</au><au>Carr, James</au><au>Markl, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients</atitle><jtitle>JACC. Cardiovascular imaging</jtitle><addtitle>JACC Cardiovasc Imaging</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>13</volume><issue>7</issue><spage>1521</spage><epage>1530</epage><pages>1521-1530</pages><issn>1936-878X</issn><eissn>1876-7591</eissn><abstract>The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients.
Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV] for assessment of interstitial expansion/fibrosis) are emerging modalities that have been investigated in various cardiomyopathies.
A total of 99 heart transplant patients underwent the magnetic resonance imaging (MRI) scans including T1- (n = 90) and T2-mapping (n = 79) techniques. Relevant clinical characteristics, MRI parameters including late gadolinium enhancement (LGE), and invasive hemodynamics were collected. Median clinical follow-up duration after the baseline scan was 2.4 to 3.5 years. Clinical outcomes include cardiac events (cardiac death, myocardial infarction, coronary revascularization, and heart failure hospitalization), noncardiac death and noncardiac hospitalization.
Overall, the global native T1, postcontrast T1, ECV, and T2 were 1,030 ± 56 ms, 458 ± 84 ms, 27 ± 4% and 50 ± 4 ms, respectively. Top-tercile-range ECV (ECV >29%) independently predicted adverse clinical outcomes compared with bottom-tercile-range ECV (ECV <25%) (hazard ratio [HR]: 2.87; 95% confidence interval [CI]: 1.07 to 7.68; p = 0.04) in a multivariable model with left ventricular end-systolic volume and LGE. Higher T2 (T2 ≥50.2 ms) independently predicted adverse clinical outcomes (HR: 3.01; 95% CI: 1.39 to 6.54; p = 0.005) after adjustment for left ventricular ejection fraction, left ventricular end-systolic volume, and LGE. Additionally, higher T2 (T2 ≥50.2 ms) also independently predicted cardiac events (HR: 4.92; CI: 1.60 to 15.14; p = 0.005) in a multivariable model with left ventricular ejection fraction.
MRI-derived myocardial ECV and T2 mapping in heart transplant patients were independently associated with cardiac and noncardiac outcomes. Our findings highlight the need for larger prospective studies.
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| ispartof | JACC. Cardiovascular imaging, 2020-07, Vol.13 (7), p.1521-1530 |
| issn | 1936-878X 1876-7591 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals |
| subjects | Contrast Media extracellular volume fraction Fibrosis Gadolinium Heart Transplantation Humans magnetic resonance imaging Magnetic Resonance Imaging, Cine Myocardium - pathology natural history Predictive Value of Tests Prognosis Prospective Studies Stroke Volume T1 mapping T2 mapping Ventricular Function, Left |
| title | Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients |
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