Utility of cardiac magnetic resonance imaging for the diagnosis of heart transplant rejection

Almenar, Luís; Igual, Begoña; Martínez‐Dolz, Luis; Arnau, Miguel Á.; Osa, Atsushi; Rueda, Joaquı́n; Palencia, M

doi:10.1016/s0041-1345(03)00653-5

Cited by 42 publications

(29 citation statements)

References 7 publications

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“…88,89 Novel methods such as nuclear perfusion and cardiac magnetic resonance imaging may have an evolving role, especially in detecting myocardial edema and increased LV mass. [90][91][92][93][94][95][96][97] One of the most promising cardiac magnetic resonance imaging modalities is T2 quantification. T2 relaxation time is the decay time constant of the magnetic signal after an excitatory pulse.…”

Section: Assessment Of Amr Imaging Modalitiesmentioning

confidence: 99%

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Colvin¹,

Cook²,

Chang³

et al. 2015

Circulation

287

251

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Section: Assessment Of Amr Imaging Modalitiesmentioning

confidence: 99%

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Colvin¹,

Cook²,

Chang³

et al. 2015

Circulation

287

251

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“…Mullen et al also observed that cTn could not accurately show acute cardiac rejection over a mean follow-up of 129 ± 9 days (14). Several non-invasive techniques have also been evaluated in this regard, including radionuclide imaging, magnetic resonance imaging, intracardiac electrogram recording, and multiparametric immune monitoring (17)(18)(19)(20). However, none of these non-invasive imaging techniques were found sufficiently reliable to replace EMB.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Role of Conventional and Tissue Doppler Imaging Echocardiography in Detection of Acute Cardiac Allograft Rejection in Heart Transplant Recipients

Haghighi

Amin

Chitsazan

et al. 2016

Int Cardiovasc Res J

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A B S T R A C T Background: Endomyocardial Biopsy (EMB) is the gold standard test for diagnosis of acute allograft cardiac rejection.Objectives: The present study aimed to assess the role of echocardiographic parameters in discriminating patients with and without evidence of acute cardiac allograft rejection. Materials and Methods: In the present cross-sectional study, using convenience sampling, 63 EMB specimens were collected from the patients who had undergone biatrial orthotropic cardiac transplantation. The mean age of the recipients and donors was 30.46 ± 9.49 and 24.55 ± 7.64 years, respectively. There were 51(81%) male recipients and 39(62%) male donors. Echocardiographic examination was performed within the 24 hours of EMB. The data were entered into the SPSS statistical software, version 19 and were analyzed by chi-square test, student's t-test, and one-way ANOVA as appropriated. All the data were two-tailed and P < 0.05 was considered to be statistically significant. Results: Among the 63 EMB specimens evaluated in the present study, mild and moderate acute rejections were seen in 19(30%) and 5(8%) cases, respectively. On Doppler examination, the three groups (without rejection, with mild rejection, and with moderate acute rejection) were significantly different only regarding trans-tricuspid E wave (P = 0.040). Pulsed-wave Tissue Doppler Imaging (TDI) also revealed a significant difference between the patients with and without allograft rejection regarding early diastolic tricuspid and mitral annular motion velocities (P = 0.005 and P = 0.02, respectively). Conclusions: It seems that echocardiographic parameters, including TDI, might be adjunct to, rather than substitution for, EMB findings for early diagnosis of acute allograft rejection. BackgroundCardiac transplantation is considered to be a life-saving treatment option for patients with end-stage heart failure. However, rejection occurs in most patients. Cardiac allograft rejection is classified into three major categories, namely hyperacute, acute, and chronic. Hyperacute rejection occurs within minutes to hours after transplantation and ►Implication for health policy/practice/research/medical education:Cardiac transplantation is a life-saving treatment option for patients with end-stage heart failure. Despite advanced immunosuppressive regimes, acute cardiac allograft rejection is still the major cause of morbidity and mortality in the first year post-transplantation. Identification of patients at an earlier stage would prevent progression to more severe disease and ultimately reduces the risk of long-term complications. In the present study, we assessed the clinical applicability of tissue Doppler imaging techniques in the early diagnosis of acute cardiac allograft rejection.

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“…A szívizomzatot érintő ödéma megítélésére a hagyomá-nyosan használt T 2 -súlyozott felvételek alapján számolt miokardiális ödéma arány (a szívizom és vázizomzat jelintenzitásának aránya) nem kellően megbízható az akut rejekció megítélésében (32)(33)(34), habár egy korábbi vizsgálatban Krieghoff és társai az ödéma arány esetén 93%-os negatív prediktív értéket állapítottak meg (20).…”

Section: T 2 -Súlyozott Mérésekunclassified

A szív MR-vizsgálat szerepe kevert típusú (humorális és celluláris) kardiális allograft rejekció esetén

Suhai¹,

Sax²,

Assabiny³

et al. 2018

Cardiologia Hungarica

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Az akut kardiális allograft rejekció a modern immunszuppresszív terápia ellenére jelenleg is az egyik vezető halálok szívtranszplantált betegek körében. Az akut rejekció kimutatásának referenciamódszere az endomiokardiális biopszia, azonban a noninvazív képalkotó diagnosztikus eljárások napjainkban e témában a tudományos kutatások fókuszába kerültek. A szív MR-(CMR) vizsgálat a bal és jobb kamra globális és regionális funkció meghatározásán túl szöveti karakterizációs képessége miatt kiemelkedik ezen modalitások közül. A kevert típusú (celluláris és humorális) rejekció ritka entitás, amelyről csak kevés irodalmi adat áll rendelkezésünkre, diagnosztikája sok esetben kihívást jelenthet. A kevert rejekció okozta CMR-eltérésekről nagyon korlátozottak az ismereteink. Az elmúlt évben három szívtranszplantált betegnél akut kevert típusú rejekciót diagnosztizáltunk, az elvégzett CMR-vizsgálat mindhárom beteg esetében nagyon hasonló eltéréseket mutatott. Egy beteg esetén kontroll CMR-vizsgálatokat is végeztünk, nyomon követve a bal és jobb kamrai ejekciós frakciók, volumenek, valamint az ödéma és késői kontraszthalmozás mintázatának változását a kezelés függvényében. A kutatás az "NVKP_16-1-2016-0017 számú projekt a Nemzeti Kutatási Fejlesztési és Innovációs Alapból biztosított támogatással, az NVKP_16 pályázati program finanszírozásában valósult meg. TheroleofCMRintheevaluationofacutemixedcardiacallograftrejectionDespite of the modern immunosuppressive therapy the acute cardiac allograft rejection is a leading cause of morbidity and mortality in heart transplant patients. Endomyocardial biopsy is considered the current gold standard for the diagnosis of acute cardiac rejection, nevertheless there is an intense research regarding on non-invasive diagnostic methods in this field. Cardiac magnetic resonance imaging (CMR) has an evolving role in the detection of acute rejection among these modalities because of its ability to quantify ventricular function and characterize the complete myocardial tissue. There are only few data of the mixed (cellular and humoral) rejection which is a very rare entity, and the diagnosis remains challenging. Our knowledge about the CMR findings of mixed cardiac rejection is limited as well. In the last year we have made a diagnosis of mixed cardiac rejection in three patients, and the subsequently performed CMR showed very similar features in each patients. We performed serial CMR examinations in one patient to follow-up the changes of left and right ventricular volumes, ejection fractions and the pattern of myocardial oedema and delayed contrast enhancement.

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Utility of cardiac magnetic resonance imaging for the diagnosis of heart transplant rejection

Cited by 42 publications

References 7 publications

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Evaluation of the Role of Conventional and Tissue Doppler Imaging Echocardiography in Detection of Acute Cardiac Allograft Rejection in Heart Transplant Recipients

A szív MR-vizsgálat szerepe kevert típusú (humorális és celluláris) kardiális allograft rejekció esetén

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