Abstract
Background Apoptotic death of interstitial cells and myocytes is a detrimental effect of the interstitial inflammatory infiltrate accompanying heart transplant rejection. This inflammatory reaction is followed by both replacement fibrosis and interstitial fibrosis which in the long term can impair diastolic and systolic ventricular (LV) function. Cardiac magnetic resonance (CMR) with gadolinium quantifies replacement fibrosis and new sequences with T1 mapping are proposed for the quantification of more elusive interstitial fibrosis. We aimed at determining the optimal T1 mapping approach to assess characteristic tissue composition in these patients.
Highlights
Apoptotic death of interstitial cells and myocytes is a detrimental effect of the interstitial inflammatory infiltrate accompanying heart transplant rejection
We studied 60 patients who underwent orthotopic heart transplant (HTx) and were free of active rejection, mean time from Tx 79 ± 79 mo age 47 ± 13 and 10 Normals (N) 39 ± 11 p = ns
In HTx native pre -contrast T1 was 1007 ± 75 vs (N) 957 ± 44 msec p < 0.001, T1 post-contrast was 400 ± 47 msec vs (N) 455 ± 35 msec p < 0.001, Extracellular volume (ECV) was 39.4 ± 4% vs 33.3 ± 3%(N) p < 0.001
Summary
Apoptotic death of interstitial cells and myocytes is a detrimental effect of the interstitial inflammatory infiltrate accompanying heart transplant rejection. This inflammatory reaction is followed by both replacement fibrosis and interstitial fibrosis which in the long term can impair diastolic and systolic ventricular (LV) function. Cardiac magnetic resonance (CMR) with gadolinium quantifies replacement fibrosis and new sequences with T1 mapping are proposed for the quantification of more elusive interstitial fibrosis. We aimed at determining the optimal T1 mapping approach to assess characteristic tissue composition in these patients
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