Evaluation of patients with systemic sclerosis prior to hematopoietic stem-cell transplantation using cardiac magnetic r
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Evaluation of patients with systemic sclerosis prior to hematopoietic stem-cell transplantation using cardiac magnetic resonance imaging Amir H Davarpanah*1, Peter Weale2, John J Sheehan1, Cormac Farrelly1, Karin Dill1, Sanjiv Shah1, Richard K Burt1 and James C Carr1 Address: 1Northwestern University, Chicago, IL, USA and 2Siemens Medical Solutuions, Chicago, IL, USA * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P259
doi:10.1186/1532-429X-12-S1-P259
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P259 © 2010 Davarpanah et al; licensee BioMed Central Ltd.
Introduction The expanding role of hematopoietic stem-cell transplantation (HSCT) for treatment of autoimmune diseases such as systemic sclerosis (SSc) necessitates efficient cardiac pre-assessment, due to transplant-related cardiovascular complications and even mortality in high-risk patients. Pulmonary hypertension (PH) is considered a major risk factor for HSCT and and current guidelines recommend using echocardiography followed by invasive right heart catheterization (RHC) for risk stratification of these patients.
ejection fraction (EF), full width at half maximum (FWHM), downslope (DS), upslope (US), time to peak velocity in systole (TPVS) and diastole (TPVD), Acceleration and Ejection time (AT & ET). These values were compared among groups and then correlated with mPAP values in all patients.
Purpose To evaluate the utility of cardiac MRI (CMR) as a tool for detection of PH and risk stratification in patients with SSc prior to HSCT.
Methods Twenty one patients with SSc who underwent CMR as part of their pre-HSCT cardiovascular evaluation and 10 controls were evaluated. Post/pre-HSCT brain natriuretic peptide (BNP) ratio as the indicator of ventricular strain was calculated in 16 patients. All patients had RHC within 2 weeks MR study and were divided into 3 groups based on their Mean Pulmonary Arterial Pressure (mPAP): MildPH, mPAP > 25; Borderline-PH, mPAP = 20 - 25; No-PH, mPAP < 20. Right ventricle (RV) volumetric & pulmonary artery (PA) flow analysis was carried out and following parameters were calculated: time to peak systole (TPS),
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Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P259
http://jcmr-online.com/content/12/S1/P259
Results There were 3 deaths in the patient group (2 mild-PH, 1 borderline-PH). Mild & borderline-PH groups had higher values of TPS, FWHM/EF ratio, TPVS, TPVD, AT, ET, BNP ratio and lower values of DS and US when compared to controls and RV volume curves showed displacement towards end of cardiac cyc
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