A comparison of myocardial perfusion and rejection in cardiac transplant patients

Abstract

This study suggests that perfusion MR imaging can be used in assessing the cardiac transplant patient for rejection related microvascular changes. The high specificity and sensitivity recorded from the ROC curve illustrates the potential utility of this diagnostic test for future studies.

Quantitative Assessment of Myocardial Perfusion MRI

“…In this study, stress MBF was significantly decreased in patients with later rejection (3.27±0.74 mL/min/g), compared with patients without later rejection (3.60±0.72 mL/min/g; P=0.067). The area under the receiver operating characteristic curve was 0.82, with a specificity and sensitivity of 75% and 81%, respectively [44].…”

“…Rivard et al [44] demonstrated that absolute MBF quantification by perfusion MRI could potentially be useful for assessing rejection-related microvascular changes in cardiac transplant patients. Acquiring tissue for histological analysis, which is a current gold standard to evaluate rejection, requires an invasive myocardial biopsy with its inherent risks.…”

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

“…88,89 Novel methods such as nuclear perfusion and cardiac magnetic resonance imaging may have an evolving role, especially in detecting myocardial edema and increased LV mass. [90][91][92][93][94][95][96][97] One of the most promising cardiac magnetic resonance imaging modalities is T2 quantification. T2 relaxation time is the decay time constant of the magnetic signal after an excitatory pulse.…”

Comprehensive Bio-Imaging Using Myocardial Perfusion Reserve Index During Cardiac Magnetic Resonance Imaging and High-Sensitive Troponin T for the Prediction of Outcomes in Heart Transplant Recipients

“…IVUS and optical coherence tomography on the other hand were not used to evaluate the wall of coronary vessels, which may show increased intimal thickness despite normal appearance on coronary angiograms (25). Humoral rejection characterized by induced and complement-mediated activation of endothelial cells and macrophages, may also have a significant impact both on myocardial perfusion and on outcomes (26,27). In our study, however, the presence of antibodymediated rejection was not systematically evaluated, which is a limitation, particularly in light of its potential impact on microvascular function (28).…”