移植小儿心脏的磁共振成像作为排斥反应的潜在预测指标
Magnetic resonance imaging of the transplanted pediatric heart as a potential predictor of rejection.
作者信息
Greenway Steven C, Dallaire Frederic, Kantor Paul F, Dipchand Anne I, Chaturvedi Rajiv R, Warade Monali, Riesenkampff Eugenie, Yoo Shi-Joon, Grosse-Wortmann Lars
机构信息
Steven C Greenway, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada.
出版信息
World J Transplant. 2016 Dec 24;6(4):751-758. doi: 10.5500/wjt.v6.i4.751.
AIM
To evaluate cardiac magnetic resonance imaging (CMR) as a non-invasive tool to detect acute cellular rejection (ACR) in children after heart transplant (HT).
METHODS
Thirty pediatric HT recipients underwent CMR at the time of surveillance endomyocardial biopsy (EMB) and results were compared to 14 non-transplant controls. Biventricular volumes, ejection fractions (EFs), T2-weighted signal intensities, native T1 times, extracellular volumes (ECVs) and presence of late gadolinium enhancement (LGE) were compared between patients and controls and between patients with International Society of Heart and Lung Transplantation (ISHLT) grade ≥ 2R rejection and those with grade 0/1R. Heart rate (HR) and brain natriuretic peptide (BNP) were assessed as potential biomarkers.
RESULTS
Significant ACR (ISHLT grade ≥ 2R) was an infrequent event in our population (5/30, 17%). Ventricular volumes, EFs, LGE prevalence, ECVs, native T1 times, T2 signal intensity ratios, HR and BNP were not associated with the presence of ≥ 2R ACR.
CONCLUSION
In this pilot study CMR did not reliably identify ACR-related changes in pediatric HT patients.
目的
评估心脏磁共振成像（CMR）作为检测儿童心脏移植（HT）后急性细胞排斥反应（ACR）的非侵入性工具。
方法
30名小儿心脏移植受者在监测性心内膜心肌活检（EMB）时接受了CMR检查，并将结果与14名非移植对照者进行比较。比较了患者和对照者之间以及国际心肺移植学会（ISHLT）分级≥2R排斥反应的患者与0/1R级患者之间的双心室容积、射血分数（EFs）、T2加权信号强度、固有T1时间、细胞外容积（ECVs）和延迟钆增强（LGE）的存在情况。评估心率（HR）和脑钠肽（BNP）作为潜在的生物标志物。
结果
在我们的研究人群中，显著的ACR（ISHLT分级≥2R）是一种罕见事件（5/30，17%）。心室容积、EFs、LGE患病率、ECVs、固有T1时间、T2信号强度比值、HR和BNP与≥2R ACR的存在无关。
结论
在这项初步研究中，CMR未能可靠地识别小儿心脏移植患者中与ACR相关的变化。
Zotero 插件