PMID- 27625368
OWN - NLM
STAT- MEDLINE
DCOM- 20171102
LR  - 20171102
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 18
IP  - 2
DP  - 2017 Feb
TI  - Prognostic impact of late gadolinium enhancement in the risk stratification of 
      heart transplant patients.
PG  - 130-137
LID - 10.1093/ehjci/jew186 [doi]
AB  - AIMS: The aim of the present study was to assess the association of the presence 
      and amount of late gadolinium enhancement (LGE) at cardiac magnetic resonance 
      (CMR) with cardiovascular adverse events in patients with orthotopic heart 
      transplantation (HTx). METHODS AND RESULTS: We enrolled 48 patients (mean age, 
      54.7 +/- 14.6 years; 37 men) at various stages after HTx. All patients underwent 
      standard CMR at 1.5 T, to characterize both cardiac anatomy and LGE. Late 
      gadolinium enhancement was detected in 26 patients (54%). All-cause and 
      cardiovascular mortalities, and a composite of major adverse cardiovascular 
      events (MACE) recurrence were evaluated during the follow-up period for a median 
      of 5.16 years. Ten patients (21%) died and 26 (54%) were readmitted because of 
      MACE. Multivariate Cox analysis identified as independent predictors of MACE a 
      diagnosis of cardiac allograft vasculopathy (CAV) (HR 3.63; 1.5-8.7 95% CI; P = 
      0.0039), left ventricular end systolic volume index (HR 1.04; 95% CI 1.01-1.079; 
      P = 0.008), LGE mass (HR 1.04; 1.01-1.06 95% CI; P = 0.0007), LGE % of left 
      ventricular mass (HR 1.083; 1.03-1.13 95% CI; P = 0.0002). Independent predictors 
      of all-cause death were CAV (HR 6.33; 95% CI 1.33-30.03; P = 0.0201), LGE mass 
      (HR 1.04; 1.01-1.07 95% CI; P = 0.005), LGE % of left ventricular mass (HR 1.075; 
      1.02-1.13 95% CI; P = 0.007). Patients with CAV had a risk of MACE by 5 years of 
      67% (95% CI 0.309-0.851%); the addition of 7.9 LGE % to the risk model increased 
      the predicted risk to 88% (95% CI 0.572-0.967%). CONCLUSIONS: The current study 
      demonstrated that the presence of CAV and the total amount of LGE have a 
      significant independent association with MACE and mortality in HTx patients.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2016. For permissions please email: journals.permissions@oup.com.
FAU - Pedrotti, Patrizia
AU  - Pedrotti P
AD  - CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Vittori, Claudia
AU  - Vittori C
AD  - CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
AD  - Heart Transplant Unit, Cardiology 2 Cardiovascular Department, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Facchetti, Rita
AU  - Facchetti R
AD  - Health Science Department, Bicocca University, Milan, Italy.
FAU - Pedretti, Stefano
AU  - Pedretti S
AD  - Cardiology 3, Cardiovascular Department, Niguarda Ca' Granda Hospital, Milan, 
      Italy.
FAU - Dellegrottaglie, Santo
AU  - Dellegrottaglie S
AD  - CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Milazzo, Angela
AU  - Milazzo A
AD  - CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Frigerio, Maria
AU  - Frigerio M
AD  - Heart Transplant Unit, Cardiology 2 Cardiovascular Department, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Cipriani, Manlio
AU  - Cipriani M
AD  - Heart Transplant Unit, Cardiology 2 Cardiovascular Department, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Giannattasio, Cristina
AU  - Giannattasio C
AD  - Health Science Department, Bicocca University, Milan, Italy.
AD  - Cardiology 4, Cardiovascular Department, Niguarda Ca' Granda Hospital, Milan, 
      Italy.
FAU - Roghi, Alberto
AU  - Roghi A
AD  - CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' 
      Granda Hospital, Milan, Italy.
FAU - Rimoldi, Ornella
AU  - Rimoldi O
AD  - CNR IBFM, Segrate, Italy rimoldi.ornella@hsr.it.
AD  - Cardiac Thoracic and Vascular Department, IRCCS Ospedale San Raffaele, Milan, 
      Italy.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20160913
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Analysis of Variance
MH  - Cause of Death
MH  - Cohort Studies
MH  - Female
MH  - *Gadolinium DTPA
MH  - Graft Rejection
MH  - Graft Survival
MH  - Heart Failure/diagnostic imaging/*mortality/*surgery
MH  - Heart Transplantation/adverse effects/*methods
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Magnetic Resonance Angiography/methods
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Radiographic Image Enhancement/*methods
MH  - Risk Adjustment
MH  - Statistics, Nonparametric
MH  - Survival Analysis
MH  - Time Factors
OTO - NOTNLM
OT  - cardiovascular magnetic resonance
OT  - coronary allograft vasculopathy
OT  - heart transplant
OT  - late gadolinium enhancement
EDAT- 2016/09/15 06:00
MHDA- 2017/11/03 06:00
CRDT- 2016/09/15 06:00
PHST- 2016/03/03 00:00 [received]
PHST- 2016/08/11 00:00 [accepted]
PHST- 2016/09/15 06:00 [pubmed]
PHST- 2017/11/03 06:00 [medline]
PHST- 2016/09/15 06:00 [entrez]
AID - jew186 [pii]
AID - 10.1093/ehjci/jew186 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2017 Feb;18(2):130-137. doi: 
      10.1093/ehjci/jew186. Epub 2016 Sep 13.