Key result
A combination of cardiac magnetic resonance imaging parameters (edema ratio and global relative enhancement) detected sub-clinical acute cellular rejection with a sensitivity of 84% and a negative predictive value of 96% compared to endomyocardial biopsy.
Why the study?
Does multi-sequential cardiac magnetic resonance imaging accurately detect sub-clinical acute cellular rejection compared to endomyocardial biopsy in heart transplant recipients?
Population
73 patients scheduled for control endomyocardial biopsy after heart transplantation, mean age 52 ± 12 years…
Comparison
Multi-sequential cardiac magnetic resonance… vs Endomyocardial biopsy with histological grading…
Design
Cross-sectional
Authors
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CMR's high NPV may aid noninvasive exclusion of sub-clinical rejection; leaves open whether it can safely reduce EMB frequency.
Cross-Sectional (n=73)
No
Does multi-sequential cardiac magnetic resonance imaging accurately detect sub-clinical acute cellular rejection compared to endomyocardial biopsy in heart transplant recipients?
Effect estimate: Sensitivity 84%, Specificity 57%, NPV 96%
Multi-sequential CMR has a high negative predictive value for excluding acute cellular rejection after heart transplantation, but its low positive predictive value means it cannot yet replace endomyocardial biopsy.
Krieghoff et al. (2014) conducted a cross-sectional in Sub-clinical acute cellular rejection after heart transplantation (n=73). Multi-sequential cardiac magnetic resonance imaging (CMR) vs. Endomyocardial biopsy (EMB) was evaluated on Diagnostic accuracy (sensitivity, specificity, NPV) for relevant acute cellular rejection (histological grade ≥1B) using a combination of edema ratio (ER) and global relative enhancement (gRE) (Sensitivity 84%, Specificity 57%, NPV 96%). A combination of cardiac magnetic resonance imaging parameters (edema ratio and global relative enhancement) detected sub-clinical acute cellular rejection with a sensitivity of 84% and a negative predictive value of 96% compared to endomyocardial biopsy.
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