Late Gadolinium Enhancement in Cardiac Transplant Patients Is Associated With Adverse Ventricular Functional Parameters and Clinical Outcomes

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• 作者：Craig R. Butler ; Andreas Kumar ; Mustafa Toma ; Richard Thompson ; Kelvin Chow ; Debra Isaac ; Daniel Kim ; Mark Haykowsky ; Matthias G. Friedrich ; Ian Paterson
• 刊名：Canadian Journal of Cardiology
• 出版年：2013
• 出版时间：September, 2013
• 年：2013
• 卷：29
• 期：9
• 页码：1076-1083
• 全文大小：852 K

文摘

Background

Heart transplant recipients (HTRs) experience multiple cardiac complications, many of which might produce myocardial fibrosis. Cardiovascular magnetic resonance imaging (CMR) can image myocardial fibrosis using late gadolinium enhancement (LGE) imaging. We hypothesized that the presence and volume of LGE in heart transplant recipients correlates with left ventricular (LV) functional parameters and clinical outcomes.

Methods

Thirty-eight stable HTRs underwent a CMR study and clinical follow-up.

Results

In 38 stable HTRs, LGE was seen in 19 patients (50 % ), of which 15 (79 % ) had a nonischemic pattern and 4 (21 % ) had an ischemic pattern. LGE volume was associated with reduced LV ejection fraction (EF) (R²?= 0.57; P?= 0.001) and increased LV end-diastolic volume (R²?= 0.59; P?= 0.001). The presence of LGE was associated with cardiovascular death or hospitalization within the next year (P?= 0.04), and patients who died or were hospitalized had more LGE than those that were not hospitalized (15 g vs 7 g; P?= 0.03).

Conclusions

LGE is common in HTR and is associated with adverse ventricular remodelling and adverse clinical outcomes. LGE might be a useful noninvasive approach to monitor graft disease in asymptomatic patients after heart transplant.