Incremental value of multiparametric cardiac magnetic resonance imaging for non-invasive identification of significant acute cardiac allograft rejection: a prospective and biopsy-proven study.
Pengyu Zhou, Zhixiang Dong, Xiaoying Hu, Shujuan Yang, Jiaxin Wang, Xuan Ma, Yun Tang, Jing Xu, Zhuxin Wei, Xi Jia, Xingrui Chen, Yujie Liu, Xiaorui Xiang, Jie Huang, Shihua Zhao
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引用次数: 0
Abstract
Aims: This study aimed to evaluate the association between cardiac magnetic resonance imaging (CMR) multiparameters and significant acute cardiac allograft rejection (SR), and assess the incremental value of CMR multiparameters over conventional serum examinations for identifying SR.
Methods and results: Heart transplantation (HTx) recipients with endomyocardial biopsy and healthy controls were prospectively recruited for CMR assessment. CMR feature tracking was performed to evaluate the left ventricular (LV) global strain in all three directions. The last serum examinations including N-terminal pro-brain natriuretic peptide (NT-proBNP) before anti-rejection therapy were recorded. Participants were divided into three groups: control, SR [acute cellular rejection grade ≥ 2R and/or antibody-mediated rejection (AMR) grade ≥ pAMR1], and NSR (non-SR). Finally, 30 controls (43.3 ± 13.6 years, 26 males) and 51 HTx recipients comprising 23 SRs (48.6 ± 12.6 years, 24 males) and 28 NSRs (42.7 ± 14.9 years, 16 males) were enrolled for analysis. Compared with NSRs, SRs showed elevated NT-proBNP (7797.0 ± 7527.6 pg/mL vs. 3334.6 ± 5935.3 pg/mL, P < 0.001), worse LV global longitudinal strain (GLS) (-9.7 ± 3.1% vs. -13.1 ± 2.9%, P < 0.001), and increased native T1 (1384 ± 80.1 ms vs. 1321 ± 69.9 ms, P < 0.001) and T2 values (50.9 ± 2.7 ms vs. 45.7 ± 4.3 ms, P < 0.001). In multivariable analysis, LVGLS (OR = 0.76, 95% CI, 0.59-0.98, P = 0.03) and T2 value (OR = 1.35, 95% CI, 1.10-1.65, P = 0.01) were independently associated with SR after NT-proBNP adjustment. Furthermore, the likelihood ratio test showed LVGLS (P = 0.002) and T2 value (P < 0.001) had incremental value over NT-proBNP for identifying SR.
Conclusion: LVGLS and T2 value were independently associated with SR, providing incremental value for non-invasive identification of significant rejection in HTx recipients.
期刊介绍：
European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology.
The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.
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