PMID- 32199848 OWN - NLM STAT- MEDLINE DCOM- 20210809 LR - 20240405 IS - 1876-7591 (Electronic) IS - 1936-878X (Print) IS - 1876-7591 (Linking) VI - 13 IP - 7 DP - 2020 Jul TI - Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients. PG - 1521-1530 LID - S1936-878X(20)30154-6 [pii] LID - 10.1016/j.jcmg.2020.01.014 [doi] AB - OBJECTIVES: The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients. BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. CI - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Chaikriangkrai, Kongkiat AU - Chaikriangkrai K AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: supersoon@gmail.com. FAU - Abbasi, Muhannad Aboud AU - Abbasi MA AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Sarnari, Roberto AU - Sarnari R AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Dolan, Ryan AU - Dolan R AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Lee, Daniel AU - Lee D AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Anderson, Allen S AU - Anderson AS AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Ghafourian, Kambiz AU - Ghafourian K AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Khan, Sadiya S AU - Khan SS AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Vorovich, Esther E AU - Vorovich EE AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Rich, Jonathan D AU - Rich JD AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Wilcox, Jane E AU - Wilcox JE AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Blaisdell, Julie A AU - Blaisdell JA AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Yancy, Clyde W AU - Yancy CW AD - Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois. FAU - Carr, James AU - Carr J AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Markl, Michael AU - Markl M AD - Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. LA - eng GR - R01 HL117888/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20200318 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM CIN - JACC Cardiovasc Imaging. 2020 Jul;13(7):1531-1533. PMID: 32305482 MH - *Contrast Media MH - Fibrosis MH - Gadolinium MH - *Heart Transplantation MH - Humans MH - Magnetic Resonance Imaging, Cine MH - Myocardium/pathology MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Stroke Volume MH - Ventricular Function, Left PMC - PMC8809107 MID - NIHMS1772217 OTO - NOTNLM OT - T1 mapping OT - T2 mapping OT - extracellular volume fraction OT - heart transplantation OT - magnetic resonance imaging OT - natural history OT - prognosis EDAT- 2020/03/23 06:00 MHDA- 2021/08/10 06:00 PMCR- 2022/02/02 CRDT- 2020/03/23 06:00 PHST- 2019/08/12 00:00 [received] PHST- 2020/01/22 00:00 [revised] PHST- 2020/01/30 00:00 [accepted] PHST- 2020/03/23 06:00 [pubmed] PHST- 2021/08/10 06:00 [medline] PHST- 2020/03/23 06:00 [entrez] PHST- 2022/02/02 00:00 [pmc-release] AID - S1936-878X(20)30154-6 [pii] AID - 10.1016/j.jcmg.2020.01.014 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2020 Jul;13(7):1521-1530. doi: 10.1016/j.jcmg.2020.01.014. Epub 2020 Mar 18.