PMID- 29728952
OWN - NLM
STAT- MEDLINE
DCOM- 20190502
LR  - 20190502
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Print)
IS  - 1569-5794 (Linking)
VI  - 34
IP  - 10
DP  - 2018 Oct
TI  - Myocardial perfusion reserve and global longitudinal strain as potential markers 
      of coronary allograft vasculopathy in late-stage orthotopic heart 
      transplantation.
PG  - 1607-1617
LID - 10.1007/s10554-018-1364-7 [doi]
AB  - Coronary allograft vasculopathy (CAV) is a major cause of mortality in late-stage 
      orthotopic heart transplantation (OHT) patients. Recent evidence has shown that 
      myocardial perfusion reserve (MPR) derived from vasodilator cardiovascular 
      magnetic resonance imaging (vCMR) and global longitudinal strain (GLS) from 
      transthoracic echocardiography (TTE) are useful to detect CAV. However, previous 
      studies have not comprehensively addressed whether these parameters are 
      confounded by allograft rejection, myocardial scar/fibrosis, or allograft 
      dysfunction. Our aim was to determine whether changes in late post-OHT MPR and 
      GLS are due to CAV or other confounding factors. Twenty OHT patients (time from 
      transplant to vCMR was 8.1 +/- 4.1 years) and 30 controls (10 healthy volunteers 
      and 20 with prior myocardial infarction to provide perspective with regards to 
      the severity of any abnormalities seen in post-OHT patients) underwent 
      vasodilator vCMR from which MPR index (MPRi), left ventricular ejection fraction 
      (LVEF), and burden of late gadolinium enhancement (LGE) were quantified. TTE was 
      used to measure GLS. The presence of CAV was determined from invasive coronary 
      angiograms using thrombolysis in myocardial infarction (TIMI) frame counts and 
      grading severity per guidelines. Previous endomyocardial biopsies were reviewed 
      to assess association with episodes of rejection. We examined the correlations 
      between MPRi and GLS with markers of CAV, allograft function, scar/fibrosis, and 
      rejection. MPRi was abnormal in post-OHT patients compared to both healthy 
      volunteers and MI controls. While there was no relationship between MPRi or GLS 
      and LVEF, episodes of rejection, or LGE burden, both MPRi and GLS were associated 
      with TIMI frame counts and presence and severity of CAV. Additionally, MPRi 
      correlated with GLS (R = 0.68, P = 0.0002). In conclusion, MPRi and GLS are 
      abnormal in late-stage OHT and associated with CAV, but not related to allograft 
      rejection, myocardial scar/fibrosis, or allograft dysfunction. Non-invasive 
      monitoring of MPRi and GLS may be a useful strategy to detect CAV.
FAU - Narang, Akhil
AU  - Narang A
AD  - Department of Medicine, University of Chicago Medicine, 5758 S. Maryland Avenue, 
      MC9067, Chicago, IL, 60637, USA.
FAU - Blair, John E
AU  - Blair JE
AD  - Department of Medicine, University of Chicago Medicine, 5758 S. Maryland Avenue, 
      MC9067, Chicago, IL, 60637, USA.
FAU - Patel, Mita B
AU  - Patel MB
AD  - Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
FAU - Mor-Avi, Victor
AU  - Mor-Avi V
AD  - Department of Medicine, University of Chicago Medicine, 5758 S. Maryland Avenue, 
      MC9067, Chicago, IL, 60637, USA.
FAU - Fedson, Savitri E
AU  - Fedson SE
AD  - Center for Medical Ethics and Health Policy, Baylor School of Medicine, Houston, 
      TX, USA.
FAU - Uriel, Nir
AU  - Uriel N
AD  - Department of Medicine, University of Chicago Medicine, 5758 S. Maryland Avenue, 
      MC9067, Chicago, IL, 60637, USA.
FAU - Lang, Roberto M
AU  - Lang RM
AD  - Department of Medicine, University of Chicago Medicine, 5758 S. Maryland Avenue, 
      MC9067, Chicago, IL, 60637, USA.
AD  - Department of Radiology, University of Chicago, Chicago, IL, USA.
FAU - Patel, Amit R
AU  - Patel AR
AD  - Department of Medicine, University of Chicago Medicine, 5758 S. Maryland Avenue, 
      MC9067, Chicago, IL, 60637, USA. amitpatel@uchicago.edu.
AD  - Department of Radiology, University of Chicago, Chicago, IL, USA. 
      amitpatel@uchicago.edu.
LA  - eng
GR  - T32 HL007381/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20180504
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
SB  - IM
MH  - Adult
MH  - Aged
MH  - Allografts/blood supply/*diagnostic imaging/physiopathology
MH  - Biopsy
MH  - Coronary Angiography
MH  - Coronary Artery Disease/*diagnostic imaging/etiology/physiopathology
MH  - *Echocardiography/methods
MH  - Endocardium/pathology
MH  - Female
MH  - Heart/diagnostic imaging/physiopathology
MH  - Heart Transplantation/*adverse effects
MH  - Humans
MH  - Infant
MH  - *Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Perfusion Imaging/*methods
MH  - Myocardium/pathology
PMC - PMC6160357
MID - NIHMS966720
OTO - NOTNLM
OT  - Allograft vasculopathy
OT  - Echocardiography
OT  - Heart transplantation
OT  - Longitudinal strain
OT  - Magnetic resonance imaging
OT  - Myocardial perfusion
EDAT- 2018/05/08 06:00
MHDA- 2019/05/03 06:00
PMCR- 2018/10/01
CRDT- 2018/05/06 06:00
PHST- 2018/02/08 00:00 [received]
PHST- 2018/04/29 00:00 [accepted]
PHST- 2018/05/08 06:00 [pubmed]
PHST- 2019/05/03 06:00 [medline]
PHST- 2018/05/06 06:00 [entrez]
PHST- 2018/10/01 00:00 [pmc-release]
AID - 10.1007/s10554-018-1364-7 [pii]
AID - 10.1007/s10554-018-1364-7 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2018 Oct;34(10):1607-1617. doi: 
      10.1007/s10554-018-1364-7. Epub 2018 May 4.