Usefulness of left ventricular peak filling rate measurement by cardiac MR imaging in heart transplant recipients with c
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Usefulness of left ventricular peak filling rate measurement by cardiac MR imaging in heart transplant recipients with cardiac allograft vasculopathy Haruhiko Machida*, Shinichi Nunoda, Kiyotaka Okajima, Kazunobu Shitakura, Akihiko Sekikawa, Kuniaki Suwa, Tomoko Kikuchi, Shun Nakajima, Miwa Hattammaru, Reiko Hozo, Tetsuya Mitsuhashi, Yutaka Kubo, Kuniaki Otsuka, Masami Hirata, Shinya Kojima, Ai Masukawa, Satoru Morita, Kazufumi Suzuki and Eiko Ueno Address: Tokyo Women's Medical University Medical Center East, Tokyo, Japan * 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):O98
doi:10.1186/1532-429X-12-S1-O98
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/O98 © 2010 Machida et al; licensee BioMed Central Ltd.
Introduction Cardiac allograft vasculopathy (CAV), a major late complication for heart transplant recipients, is characterized as a diffuse intimal hyperplasia of the coronary artery. Invasive coronary angiography and coronary flow reserve (CFR) measurement are often performed, but have some limitations for CAV screening of asymptomatic recipients. This vasculopathy usually accelerates left ventricular (LV) diastolic dysfunction before systolic dysfunction. It has not been fully investigated which is more useful for detecting CAV, cardiac MR measurement of peak filling rate (PFR) as an index of LV diastolic function or invasive CFR measurement.
measured LV PFR normalized to end-diastolic volume (EDV) and ejection fraction (EF) by steady-state free precession cine MR imaging. We measured coronary flow reserve as ratio of maximal hyperemic to baseline coronary flow velocity by Doppler guidewire in 47 (90%) of these 52 recipients. According to Stanford classification based on intimal wall morphology assessed by IVUS, we classified recipients of grade 0-2 as negative and grade 3-4 as positive for CAV and compared the PFR, EF, and CFR values between the 2 groups using unpaired t-test. We calculated receiver operating characteristic (ROC) curve in the relationship between PFR value and CAV and determined PFR cut-off value. Likewise, we classified recipients of low and high PFR based on the cut-off value and com-
Purpose We investigated the feasibility of noninvasive PFR measurement by MR for detecting CAV over invasive CFR measurement in recipients.
Table 1:
CAV negative
CAV positive
P value
CFR
3.34 ± 0.87
3.06 ± 1.17
0.340
EF (%)
59.8 ± 7.8
57.7 ± 8.5
0.359
PFR (EDV/sec)
4.44 ± 0.87
3.68 ± 0.89
0.003
Methods Between June 2006 and June 2009, 52 asymptomatic recipients (35 men, 17 women, aged 35.1 ± 15.4 years) underwent both cardiac MR and intravascular u
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