Native T1 Mapping in the Diagnosis of Cardiac Allograft Rejection: A Prospective Histologically Validated Study.
Imran, M
Wang, L
McCrohon, J
Yu, C
Holloway, C
Otton, J
Huang, J
Stehning, C
Moffat, KJ
Ross, J
Puntmann, VO
Vassiliou, VS
Prasad, S
Kotlyar, E
Keogh, A
Hayward, C
Macdonald, P
Jabbour, A
- Publication Type:
- Journal Article
- Citation:
- JACC Cardiovasc Imaging, 2019, 12 (8 Pt 2), pp. 1618 - 1628
- Issue Date:
- 2019-08
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Imran, M | en_US |
dc.contributor.author | Wang, L | en_US |
dc.contributor.author | McCrohon, J | en_US |
dc.contributor.author | Yu, C | en_US |
dc.contributor.author | Holloway, C | en_US |
dc.contributor.author | Otton, J | en_US |
dc.contributor.author | Huang, J | en_US |
dc.contributor.author | Stehning, C | en_US |
dc.contributor.author | Moffat, KJ | en_US |
dc.contributor.author | Ross, J | en_US |
dc.contributor.author | Puntmann, VO | en_US |
dc.contributor.author | Vassiliou, VS | en_US |
dc.contributor.author | Prasad, S | en_US |
dc.contributor.author | Kotlyar, E | en_US |
dc.contributor.author | Keogh, A | en_US |
dc.contributor.author | Hayward, C | en_US |
dc.contributor.author |
Macdonald, P https://orcid.org/0000-0001-5378-2825 |
en_US |
dc.contributor.author | Jabbour, A | en_US |
dc.date.accessioned | 2020-04-16T06:39:51Z | |
dc.date.available | 2020-08-01T19:10:15Z | |
dc.date.issued | 2019-08 | en_US |
dc.identifier.citation | JACC Cardiovasc Imaging, 2019, 12 (8 Pt 2), pp. 1618 - 1628 | en_US |
dc.identifier.uri | http://hdl.handle.net/10453/140035 | |
dc.description.abstract | OBJECTIVES: This study aimed to determine the role of T1 mapping in identifying cardiac allograft rejection. BACKGROUND: Endomyocardial biopsy (EMBx), the current gold standard to diagnose cardiac allograft rejection, is associated with potentially serious complications. Cardiac magnetic resonance (CMR)-based T1 mapping detects interstitial edema and fibrosis, which are important markers of acute and chronic rejection. Therefore, T1 mapping can potentially diagnose cardiac allograft rejection noninvasively. METHODS: Patients underwent CMR within 24 h of EMBx. T1 maps were acquired at 1.5-T. EMBx-determined rejection was graded according to International Society of Heart and Lung Transplant (ISHLT) criteria. RESULTS: Of 112 biopsies with simultaneous CMR, 60 were classified as group 0 (ISHLT grade 0), 35 as group 1 (ISHLT grade 1R), and 17 as group 2 (2R, 3R, clinically diagnosed rejection, antibody-mediated rejection). Native T1 values in patients with grade 0 biopsies and left ventricular ejection fraction >60% (983 ± 42 ms; 95% confidence interval: 972 to 994 ms) were comparable to values in nontransplant healthy control subjects (974 ± 45 ms; 95% confidence interval: 962 to 987 ms). T1 values were significantly higher in group 2 (1,066 ± 78 ms) versus group 0 (984 ± 42 ms; p = 0.0001) and versus group 1 (1,001 ± 54 ms; p = 0.001). After excluding patients with an estimated glomerular filtration rate <50 ml/min/m2, there was a moderate correlation of log-transformed native T1 with high-sensitivity troponin T (r = 0.54, p < 0.0001) and pro-B-type natriuretic peptide (r = 0.67, p < 0.0001). Using a T1 cutoff value of 1,029 ms, the sensitivity, specificity, and negative predictive value were 93%, 79%, and 99%, respectively. CONCLUSIONS: Myocardial tissue characterization with T1 mapping displays excellent negative predictive capacity for the noninvasive detection of cardiac allograft rejection and holds promise to reduce substantially the EMBx requirement in cardiac transplant rejection surveillance. | en_US |
dc.language | eng | en_US |
dc.relation.ispartof | JACC Cardiovasc Imaging | en_US |
dc.relation.isbasedon | 10.1016/j.jcmg.2018.10.027 | en_US |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject.classification | Cardiovascular System & Hematology | en_US |
dc.subject.mesh | Myocardium | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Edema, Cardiac | en_US |
dc.subject.mesh | Fibrosis | en_US |
dc.subject.mesh | Magnetic Resonance Imaging, Cine | en_US |
dc.subject.mesh | Stroke Volume | en_US |
dc.subject.mesh | Biopsy | en_US |
dc.subject.mesh | Treatment Outcome | en_US |
dc.subject.mesh | Heart Transplantation | en_US |
dc.subject.mesh | Case-Control Studies | en_US |
dc.subject.mesh | Prospective Studies | en_US |
dc.subject.mesh | Cross-Sectional Studies | en_US |
dc.subject.mesh | Predictive Value of Tests | en_US |
dc.subject.mesh | Graft Rejection | en_US |
dc.subject.mesh | Ventricular Function, Left | en_US |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Young Adult | en_US |
dc.subject.mesh | Allografts | en_US |
dc.title | Native T1 Mapping in the Diagnosis of Cardiac Allograft Rejection: A Prospective Histologically Validated Study. | en_US |
dc.type | Journal Article | |
utslib.citation.volume | 8 Pt 2 | en_US |
utslib.citation.volume | 12 | en_US |
utslib.location.activity | United States | en_US |
utslib.for | 1102 Cardiorespiratory Medicine and Haematology | en_US |
utslib.for | 1103 Clinical Sciences | en_US |
pubs.embargo.period | Not known | en_US |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
utslib.copyright.status | open_access | * |
pubs.issue | 8 Pt 2 | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 12 | en_US |
Abstract:
OBJECTIVES: This study aimed to determine the role of T1 mapping in identifying cardiac allograft rejection. BACKGROUND: Endomyocardial biopsy (EMBx), the current gold standard to diagnose cardiac allograft rejection, is associated with potentially serious complications. Cardiac magnetic resonance (CMR)-based T1 mapping detects interstitial edema and fibrosis, which are important markers of acute and chronic rejection. Therefore, T1 mapping can potentially diagnose cardiac allograft rejection noninvasively. METHODS: Patients underwent CMR within 24 h of EMBx. T1 maps were acquired at 1.5-T. EMBx-determined rejection was graded according to International Society of Heart and Lung Transplant (ISHLT) criteria. RESULTS: Of 112 biopsies with simultaneous CMR, 60 were classified as group 0 (ISHLT grade 0), 35 as group 1 (ISHLT grade 1R), and 17 as group 2 (2R, 3R, clinically diagnosed rejection, antibody-mediated rejection). Native T1 values in patients with grade 0 biopsies and left ventricular ejection fraction >60% (983 ± 42 ms; 95% confidence interval: 972 to 994 ms) were comparable to values in nontransplant healthy control subjects (974 ± 45 ms; 95% confidence interval: 962 to 987 ms). T1 values were significantly higher in group 2 (1,066 ± 78 ms) versus group 0 (984 ± 42 ms; p = 0.0001) and versus group 1 (1,001 ± 54 ms; p = 0.001). After excluding patients with an estimated glomerular filtration rate <50 ml/min/m2, there was a moderate correlation of log-transformed native T1 with high-sensitivity troponin T (r = 0.54, p < 0.0001) and pro-B-type natriuretic peptide (r = 0.67, p < 0.0001). Using a T1 cutoff value of 1,029 ms, the sensitivity, specificity, and negative predictive value were 93%, 79%, and 99%, respectively. CONCLUSIONS: Myocardial tissue characterization with T1 mapping displays excellent negative predictive capacity for the noninvasive detection of cardiac allograft rejection and holds promise to reduce substantially the EMBx requirement in cardiac transplant rejection surveillance.
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