Abstract
Objectives
To describe the dynamic changes in cardiac deformation and tissue characteristics using cardiac magnetic resonance (CMR) in asymptomatic patients during 12 months after heart transplantation (HT).
Methods
From April 2020 to January 2021, 21 consecutive HT patients without clinical symptoms were included in this prospective study. Multiparametric CMR was performed at 3, 6, and 12 months after HT. Twenty-five healthy volunteers served as controls.
Results
During follow-up, a decline in left ventricular (LV) global radial strain (GRS) (p = 0.020) and right ventricular (RV) global longitudinal strain (GLS) (p < 0.001) and an increase in post-contrast T1 (p = 0.024) and T2 (p < 0.001) in asymptomatic HT patients occurred at 3 months, which normalized at 6 months postoperatively, compared with those in healthy controls. A decline in LVGLS (p < 0.001) and LV global circumferential strain (GCS) (p < 0.001) and an increase in native T1 (p < 0.001), T2 (p < 0.001), and extracellular volume (ECV) (p < 0.001) occurred at 3 months. Although most parameters improved gradually, LVGLS, native T1, and ECV remained abnormal compared with those in healthy controls at 12 months; only T2 and LVGCS were normalized at 6 months and 12 months, respectively. ECV was significantly correlated with LVGLS, LVGCS, and LVGRS.
Conclusion
Cardiac deformation and tissue characteristics were abnormal early after HT, although the patients were clinically asymptomatic. The dynamic changes in CMR characteristics demonstrate a gradual recovery of myocardial injury associated with transplantation during the first 12 months after HT.
Key Points
• Multiparametric CMR can detect the dynamic changes of transplantation-associated myocardial injury.
• Post-contrast T1, T2, LVGRS, and RVGLS values are normalized at 6 months after HT.
• Native T1, ECV, and LVGLS values remain abnormal compared with those in healthy controls at 12 months after HT.
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Change history
08 May 2023
A Correction to this paper has been published: https://doi.org/10.1007/s00330-023-09531-1
Abbreviations
- AR:
-
Allograft rejection
- CAV:
-
Cardiac allograft vasculopathy
- CMR:
-
Cardiac magnetic resonance
- ECV:
-
Extracellular volume
- hsTnT:
-
High-sensitivity troponin T
- HT:
-
Heart transplantation
- LGE:
-
Late gadolinium enhancement
- LV:
-
Left ventricular
- LVEF:
-
Left ventricular ejection fraction
- LVGCS:
-
Left ventricular global circumferential strain
- LVGLS:
-
Left ventricular global longitudinal strain
- LVGRS:
-
Left ventricular global radial strain
- LVmassi:
-
Left ventricular mass index
- NT-proBNP:
-
N-terminal pro-brain natriuretic peptide
- RVGLS:
-
Right ventricular global longitudinal strain
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Funding
This work was supported by the National Natural Science Foundation of China (Grant No. 81974262 and 81970288); the Natural Science Foundation of Guangdong Province (Grant No. 2020A1515010650); the Guangdong Cardiovascular Institute Project (Grant No.2020XXG009); and the Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application (Grant No. 2022B1212010011).
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The scientific guarantor of this publication is Hui Liu.
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• performed at one institution
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Yang, Y., Li, T., Zhou, X. et al. Multiparametric cardiovascular magnetic resonance characteristics and dynamic changes in asymptomatic heart-transplanted patients. Eur Radiol 33, 4600–4610 (2023). https://doi.org/10.1007/s00330-022-09358-2
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DOI: https://doi.org/10.1007/s00330-022-09358-2