Children after heart transplantation had significantly higher native T1 times in the entire LV myocardium compared to healthy controls (987 vs 951 ms; P<0.005), indicating diffuse myocardial fibrosis.
Observational (n=26)
Is diffuse myocardial fibrosis increased in children after heart transplantation compared to healthy controls?
Children after heart transplantation show evidence of diffuse myocardial fibrosis on CMR, which correlates with diastolic dysfunction.
Absolute Event Rate: 987% vs 951%
p-value: p=<0.005
BACKGROUND: It is unclear whether the myocardium undergoes accelerated fibrotic remodeling in children after heart transplantation (HTx). METHODS: In this prospective study, cardiac magnetic resonance (CMR) studies in 17 patients 1.3 years (median, range 0.03-12.6 years) after HTx (mean age, 9.8 ± 6.2 years; 8 girls) were compared to CMR studies in 9 healthy controls (mean age, 12.4 ± 2.4 years; 4 girls). T1 measurements were performed at a midventricular short axis slice before (ie, native T1 times) and after the application of 0.2 mmol/kg gadopentetate dimeglumine in the interventricular septum, left ventricular (LV) free wall and encompassing the entire LV myocardium. The tissue-blood partition coefficient (TBPC), reflecting the degree of diffuse myocardial fibrosis, was calculated as a function of the ratio of T1 change of myocardium compared to blood. Native T1 times and TBPC were correlated with echocardiographic parameters of diastolic function. RESULTS: Native T1 times were significantly higher in HTx patients compared to controls in all regions assessed (LV free wall 973 ± 42 vs 923 ± 12 ms; P < 0.005; interventricular septum 1003 ± 31 vs 974 ± 21 ms, P < 0.05; entire LV myocardium 987 ± 33 vs 951 ± 16 ms; P < 0.005) and correlated with LV E/e' as an echocardiographic marker of diastolic dysfunction (r = 0.54, P < 0.05). The TBPC was elevated in the LV free wall (0.45 ± 0.06 vs 0.40 ± 0.03, P < 0.005) and the entire LV myocardium (0.47 ± 0.06 vs 0.43 ± 0.03, P < 0.05). CONCLUSIONS: Evidence of diffuse myocardial fibrosis and is already present in children after HTx. It appears to be associated with diastolic dysfunction.
Riesenkampff et al. (Tue,) conducted a observational in Heart transplantation (n=26). Heart transplantation vs. Healthy controls was evaluated on Native T1 times in the entire LV myocardium (ms) (p=<0.005). Children after heart transplantation had significantly higher native T1 times in the entire LV myocardium compared to healthy controls (987 vs 951 ms; P<0.005), indicating diffuse myocardial fibrosis.