Dolan Ryan S, Rahsepar Amir A, Blaisdell Julie, Sarnari Roberto, Ghafourian Kambiz, Wilcox Jane E, Khan Sadiya S, Vorovich Esther E, Rich Jonathan D, Yancy Clyde W, Anderson Allen S, Carr James C, Markl Michael
Department of Radiology, Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (R.S.D., A.A.R., J.B., R.S., J.C.C., M.M.); Department of Cardiology, Northwestern University, Chicago, Ill (K.G., J.E.W., S.S.K., E.E.V., J.D.R., C.W.Y., A.S.A.); and Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, Ill (M.M.).
Radiol Cardiothorac Imaging. 2019 Dec 19;1(5):e190009. doi: 10.1148/ryct.2019190009.
To use structure-function cardiac MRI in the evaluation of relationships between donor and heart transplantation (HTx) recipient characteristics and changes in cardiac tissue structure and function. HTx candidates and donor hearts are evaluated for donor-recipient matches to improve survival, but the impact of donor and recipient characteristics on changes in myocardial tissue and function in the transplanted heart is not fully understood.
Cardiac MRI at 1.5 T was performed from August 2014 to June 2017 in 58 HTx recipients (mean age, 51.1 years ± 12.6 [standard deviation], 26 female patients) and included T2 mapping (to evaluate edematous and/or inflammatory changes), precontrast and postcontrast T1 mapping (allowing the calculation of extracellular volume fraction [ECV] to estimate interstitial expansion), and tissue phase mapping (allowing the calculation of myocardial velocities and twist). Donor and recipient demographics (age, sex, height, weight, and body mass index [BMI]) and comorbidities (hypertension, diabetes, and smoking history) were evaluated for relationships with cardiac MRI measures.
Sex-influenced cardiac MRI measures of myocardial tissue and function are as follows: Female HTx recipients demonstrated increased precontrast T1 ( = .002) and reduced systolic peak long-axis velocities ( = .015). Increased age of the donor heart was associated with elevated T2 ( = 0.32; < .05) and ECV ( = 0.47; < .01), indicating increased edema and interstitial expansion, as well as impaired diastolic peak long-axis velocities ( = 0.41; < .01). Recipient-donor differences in age, weight, and BMI were significantly associated with elevated ECV ( = 0.36-0.48; < .05). Hypertension in donors resulted in increased ECV (31.0% ± 4.2 vs 26.0% ± 3.3; = .001).
Donor and HTx recipient characteristics were significantly associated with cardiac MRI-derived measures of myocardial tissue structure and function.© RSNA, 2019.
运用心脏结构-功能磁共振成像（MRI）评估心脏移植供体与受体特征之间的关系以及心脏组织结构和功能的变化。心脏移植候选者和供体心脏会接受供体-受体匹配评估以提高生存率，但供体和受体特征对移植心脏心肌组织和功能变化的影响尚未完全明确。
2014年8月至2017年6月，对58例心脏移植受体（平均年龄51.1岁±12.6[标准差]，26例女性患者）进行1.5T心脏MRI检查，包括T2 mapping（评估水肿和/或炎症变化）、对比剂前和对比剂后T1 mapping（计算细胞外容积分数[ECV]以估计间质扩张）以及组织相位映射（计算心肌速度和扭转）；评估供体和受体人口统计学特征（年龄、性别、身高、体重和体重指数[BMI]）以及合并症（高血压、糖尿病和吸烟史）与心脏MRI测量值之间的关系。
性别影响心肌组织和功能的心脏MRI测量值如下：女性心脏移植受体对比剂前T1升高（P = 0.002），收缩期峰值长轴速度降低（P = 0.015）。供体心脏年龄增加与T2升高（P = 0.32；P < 0.05）和ECV升高（P = 0.47；P < 0.01）相关，表明水肿增加和间质扩张，以及舒张期峰值长轴速度受损（P = 0.41；P < 0.01）。受体与供体在年龄、体重和BMI方面的差异与ECV升高显著相关（P = 0.36 - 0.48；P < 0.05）。供体患有高血压导致ECV升高（31.0%±4.2对26.0%±3.3；P = 0.001）。
供体和心脏移植受体特征与心脏MRI得出的心肌组织结构和功能测量值显著相关。©RSNA，2019。
