Diffuse Myocardial Fibrosis in Children After Heart Transplantations

Riesenkampff, Eugénie; Chen, Ching Kit; Kantor, Paul F; Greenway, Steven C.; Chaturvedi, Rajiv; Yoo, Shi Joon; Greiser, Andreas; Dipchand, Anne I.; Grosse-Wortmann, Lars

doi:10.1097/tp.0000000000000769

Cited by 26 publications

(20 citation statements)

References 40 publications

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“…,26 RAF has been studied in adults with the bi-caval technique showing a marked decrease in atrial reservoir function compared to controls as seen in our population 27. RA minimum area and RA EF% were also different in the Bech-Hansenn et al study as well, similar to our cohort.…”

supporting

confidence: 87%

“…RAF was significantly decreased in our PHTx population regardless of comorbidities compared to normal controls, consistent with suggested signs of baseline diastolic dysfunction of transplanted hearts that has been previously reported by others . RAF has been studied in adults with the bi‐caval technique showing a marked decrease in atrial reservoir function compared to controls as seen in our population .…”

Section: Discussionmentioning

confidence: 99%

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Right atrial function in pediatric heart transplant patients by echocardiographic strain measurements

Watanabe

Schäfer

Cassidy

et al. 2019

Pediatric Transplantation

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Background CAV is a major cause of mortality in PHTx patients. Research on echocardiographic indices to detect CAV focuses primarily on ventricular function and less is known about RAF. Thus, we primarily sought to evaluate RAF in PHTx patients with CAV. For secondary analysis, we compared RAF between PHTx patients and control patients and evaluated RAF with respect to rejection and surgical type. Methods We retrospectively evaluated echocardiography derived RA strain indices in recipients <18 years old and >1 year from time of transplant. The RA strain phases included, reservoir (εs), conduit (εe), pump (εa), and respective strain rate indices (SRs, SRe, SRa). Results There were 36 PHTx patients and 14 age‐, sex‐matched control patients. There was a significant reduction in εs, εe, SRs, and SRe (P < 0.001) in the PHTx patients when compared to controls. There was no difference between the CAV (+) and CAV (−) patients with respect to RAF indices. Furthermore, εs, εe, and SRe (P < 0.05) were lower in patients with acute rejection (n = 7) compared to those without (n = 26). Patients with a bi‐atrial anastomosis (n = 14) had decreased εs, εa, SRs, SRa (P < 0.05), compared to bi‐caval anastomosis (n = 24). Conclusion PHTx patients have decreased RAF compared to healthy children. RAF does not differentiate PHTx patients based on the presence of CAV. RAF is also decreased in PHTx patients with rejection and in those transplanted with a bi‐atrial anastomosis.

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supporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Right atrial function in pediatric heart transplant patients by echocardiographic strain measurements

Watanabe

Schäfer

Cassidy

et al. 2019

Pediatric Transplantation

View full text Add to dashboard Cite

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“…Bracco Imaging, Montreal, Canada), using a modified Look-Locker inversion (MOLLI) sequence as previously described (13). In brief, two inversion-recovery prepared ECG synchronized Look-Locker acquisitions were performed with inversion pulses of 120 ms and 200 ms, respectively, followed by 5 and 3 single-shot images after these inversion pulses.…”

Section: Cardiac Magnetic Resonancementioning

confidence: 99%

Pediatric Fontan patients are at risk for myocardial fibrotic remodeling and dysfunction

Kato

Riesenkampff

Yim

et al. 2017

International Journal of Cardiology

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“…Published data on CMR quantification of myocardial fibrosis after HT are very limited and have used a variety of methodologies, including native T1 mapping, post-contrast T1 mapping, and ECV. [42][43][44][45] In the most pertinent study, Ide et al 45 DMF and diastolic dysfunction. 42 Although we did not find an association of ECV with ventricular filling pressures in our cohort, we did find ECV correlated with BNP levels, a marker of both systolic and diastolic dysfunction.…”

Section: F I G U R E 3 Representative Raw Cmr Images and Ecv Maps Of mentioning

confidence: 99%

Diffuse myocardial fibrosis among healthy pediatric heart transplant recipients: Correlation of histology, cardiovascular magnetic resonance, and clinical phenotype

Feingold

Salgado

Reyes‐Múgica

et al. 2017

Pediatric Transplantation

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Fibrosis is commonly described in heart allografts lost late after transplantation. CMR-derived ECV is a validated measure of DMF in native adult hearts that may predict heart failure and mortality. We explored associations of ECV with histologic myocardial fibrosis and clinical features after pediatric heart transplantation. Twenty-five recipients (7.0±6.3 years at transplant and 10.7±6.5 years post-transplant) were prospectively recruited for CMR and BNP measurement at the time of surveillance biopsy. All had normal ejection fractions and lacked heart failure symptoms. Fibrosis was quantified on biopsy after picrosirius red staining as CVF. ECV was quantified using contemporaneous hematocrit on basal and mid-short-axis slices. ECV was moderately correlated with CVF (r=.47; P=.019). We found no associations of ECV with hemodynamics, ischemic time, time since transplantation, or number of prior biopsies or acute rejections. Compared to healthy non-transplant controls, there was no significant difference in ECV (25.1±3.0 vs 23.7±2.0%, P=.09). Log-transformed BNP was correlated with ECV (recipients: r=.46, P=.02; recipients and controls: r=.45, P=.006). These findings suggest ECV quantifies DMF and relates to biological indicators of cardiac function after pediatric heart transplantation.

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Diffuse Myocardial Fibrosis in Children After Heart Transplantations

Abstract: Evidence of diffuse myocardial fibrosis and is already present in children after HTx. It appears to be associated with diastolic dysfunction.

Cited by 26 publications

References 40 publications

Right atrial function in pediatric heart transplant patients by echocardiographic strain measurements

Right atrial function in pediatric heart transplant patients by echocardiographic strain measurements

Pediatric Fontan patients are at risk for myocardial fibrotic remodeling and dysfunction

Diffuse myocardial fibrosis among healthy pediatric heart transplant recipients: Correlation of histology, cardiovascular magnetic resonance, and clinical phenotype

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