Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: We hypothesize that acute cellular rejection (ACR) episodes during the first year post heart transplant (HTx) may lead to structural and functional alterations of the myocardium, which can be non-invasively assessed by cardiac magnetic resonance imaging (CMR).
*Methods: HTx patients (50±13 years, 14 male) underwent 49 CMR scans during year one post-HTx (1-4 scans per patient). CMR included left ventricular (LV) T1 mapping for calculation of native T1 time, which is a measure for structural changes in the myocardium and is increased in the presence of inflammation or interstitial expansion. Biventricular cardiac motion was assessed using tissue phase mapping (TPM), a CMR modality that measures myocardial velocities in all three principal motion directions (long-axis, radial, circumferential) of left and right ventricle (LV/RV) over the course of the cardiac cycle. Positive values represent radial contraction and long-axis shortening. In addition, LV and RV ejection fractions (EF) were calculated by standard global function analysis using cine short-axis images. Rejection episodes were diagnosed by endomyocardial biopsy (EMB) and the number of ACR episodes preceding each CMR scan was recorded (2R counted twice).
*Results: Patients were diagnosed with a total of 115 mild (1R, 4.8±2.7 per patient) and 9 moderate (2R, 0.4±0.6 per patient) ACR episodes. Increasing number of ACR episodes was significantly associated with elevated LV T1 time (r=0.36,p=0.01) and with a reduction of biventricular peak velocities during systolic contraction, for the LV in long-axis (peak vz, r=-0.37,p=0.01) and for the RV in radial (peak vr, r=-0.32,p=0.02) direction. No significant correlations were found between biventricular EF and number of ACR episodes.
*Conclusions: Multiple ACR episodes occurring during the first year post-HTx show an impact on structure and systolic velocities of graft myocardium, whereas standard global function parameters are not affected. CMR is a valid tool for graft monitoring post-HTx and has the potential to valuably complement histological information provided by EMB in patients undergoing repetitive ACR episodes.
To cite this abstract in AMA style:Sarnari R, Ruh A, Abbasi M, Blaisdell J, Dolan R, Wilcox J, Khan S, Vorovich E, Rich J, Anderson A, Yancy C, Carr J, Markl M, Ghafourian K. Alteration of Myocardial Velocities and T1 Times in Patients with Acute Cellular Rejection during First Year Post Heart Transplant [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/alteration-of-myocardial-velocities-and-t1-times-in-patients-with-acute-cellular-rejection-during-first-year-post-heart-transplant/. Accessed September 18, 2019.
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