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Cardiac Structure-Function MRI in Patients After Heart Transplantation
Ryan S Dolan1, Amir A Rahsepar1, Julie Blaisdell1
1Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of Magnetic Resonance Imaging : JMRI
|August 25, 2018
Summary
Cardiac MRI effectively detects structural and functional changes in heart transplant recipients. This noninvasive imaging reveals abnormalities in myocardial edema, interstitial expansion, and impaired systolic function, correlating with transplant-related cardiac issues.
Area of Science:
- Cardiovascular Imaging
- Transplant Medicine
- Biomedical Engineering
Background:
- Current monitoring of heart transplant recipients relies on invasive endomyocardial biopsy and limited echocardiography.
- These methods present challenges in terms of cost, invasiveness, and detailed structural and functional assessment.
- There is a need for a comprehensive, noninvasive method to evaluate cardiac changes post-transplantation.
Purpose of the Study:
- To assess the feasibility of using comprehensive structure-function cardiac MRI.
- To evaluate cardiac MRI as a noninvasive tool for detecting myocardial structural and functional changes in heart transplant recipients.
Main Methods:
- A prospective study involving 61 heart transplant recipients and 14 healthy controls.
- Utilized 1.5T MRI with 2D CINE SSFP, T2-mapping, T1-mapping (pre- and post-gadolinium), and tissue-phase mapping (TPM).
- Quantified myocardial T2 (edema), T1 (interstitial expansion via ECV), and TPM-derived LV velocities, dyssynchrony, and twist.
Main Results:
- Heart transplant recipients showed significantly elevated T2 and T1 values compared to controls, indicating myocardial edema and interstitial expansion.
- Impaired systolic longitudinal function was observed in recipients, characterized by reduced peak systolic velocities and increased dyssynchrony.
- Significant correlations were found between structural measures (T2, T1, ECV) and functional parameters (velocities, dyssynchrony), highlighting a structure-function relationship.
Conclusions:
- Cardiac MRI techniques are sensitive in identifying structural and functional differences in heart transplant recipients.
- The study demonstrates a significant association between cardiac structural abnormalities (edema, interstitial expansion) and functional deficits (impaired contractility, dyssynchrony).
- Comprehensive cardiac MRI offers a promising noninvasive approach for monitoring heart transplant recipients.
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