Native T1 mapping detects both acute clinical rejection and graft dysfunction in pediatric heart transplant patients.
Native T1 mapping detects both acute clinical rejection and graft dysfunction in pediatric heart transplant patients.
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天然T1映射检测小儿心脏移植患者的急性临床排斥和移植功能障碍。
DOI：
10.1186/s12968-022-00875-z
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发表时间：
2022-10-03
影响因子：
6.4
通讯作者：
Olivieri, Laura
中科院分区：
文献类型：
--
作者：
Richmann, Devika P.;Gurijala, Nyshidha;Mandell, Jason G.;Doshi, Ashish;Hamman, Karin;Rossi, Christopher;Rosenberg, Avi Z.;Cross, Russell;Kanter, Joshua;Berger, John T., III;Olivieri, Laura
关键词：
心血管磁共振（CMR）正在成为心脏移植评估的重要工具。天然T1标测可增加识别排斥反应和评估移植物功能障碍和心肌纤维化负荷的价值。我们假设CMR天然T1值和T1图纹理分析的特征将识别急性排斥反应，并且在二次分析中，与移植物功能障碍的标志物和来自肌内膜活检（EMB）的纤维化百分比相关。对24名儿童受试者进行了50例同时EMB、右心导管插入术和1.5 T CMR，并通过8个短轴切片中的改良Look-Roll反转恢复（MOLLI）进行屏气T1标测，随后对平均和峰值天然T1值进行定量。使用9个灰度共生矩阵特征对单个心室中段切片进行图像纹理分析。Masson三色染色的EMB样本的数字定量确定了纤维化程度。收集移植物功能障碍的标志物，包括血清脑钠肽水平和超声心动图、导管插入术和CMR的血流动力学测量值。受试者根据排斥程度分为三组：需要新治疗的急性排斥，需要增加持续治疗的轻度排斥，以及无排斥且治疗不变。统计分析包括学生t检验和线性回归。 峰值和平均T1值与急性排斥反应显著相关，随着排斥反应等级的增加观察到单调趋势。纹理分析显示T1值的空间异质性更大，如能量、熵和方差所示，在需要治疗的情况下。有趣的是，尽管EMB结果低级别，但需要增加治疗的2例受试者的T1峰值异常。峰值T1值也与BNP、右侧充盈压和毛细血管楔压升高相关。3组间组织病理学纤维化百分比无差异;组织病理学纤维化与T1值或移植物功能障碍标志物无关。在儿科心脏移植患者中，天然T1值可识别需要治疗的急性排斥反应，并可识别移植物功能障碍。CMR显示出作为儿童心脏移植物评估的重要工具的前景，T1成像在评估排斥反应方面优于活检结果。在线版本包含补充材料，可通过10.1186/s12968 - 022 - 00875-z获得。
Cardiovascular magnetic resonance (CMR) is emerging as an important tool for cardiac allograft assessment. Native T1 mapping may add value in identifying rejection and in assessing graft dysfunction and myocardial fibrosis burden. We hypothesized that CMR native T1 values and features of textural analysis of T1 maps would identify acute rejection, and in a secondary analysis, correlate with markers of graft dysfunction, and with fibrosis percentage from endomyocardial biopsy (EMB). Fifty cases with simultaneous EMB, right heart catheterization, and 1.5 T CMR with breath-held T1 mapping via modified Look-Locker inversion recovery (MOLLI) in 8 short-axis slices and subsequent quantification of mean and peak native T1 values, were performed on 24 pediatric subjects. A single mid-ventricular slice was used for image texture analysis using nine gray-level co-occurrence matrix features. Digital quantification of Masson trichrome stained EMB samples established degree of fibrosis. Markers of graft dysfunction, including serum brain natriuretic peptide levels and hemodynamic measurements from echocardiography, catheterization, and CMR were collated. Subjects were divided into three groups based on degree of rejection: acute rejection requiring new therapy, mild rejection requiring increased ongoing therapy, and no rejection with no change in treatment. Statistical analysis included student’s t-test and linear regression. Peak and mean T1 values were significantly associated with acute rejection, with a monotonic trend observed with increased grade of rejection. Texture analysis demonstrated greater spatial heterogeneity in T1 values, as demonstrated by energy, entropy, and variance, in cases requiring treatment. Interestingly, 2 subjects who required increased therapy despite low grade EMB results had abnormal peak T1 values. Peak T1 values also correlated with increased BNP, right-sided filling pressures, and capillary wedge pressures. There was no difference in histopathological fibrosis percentage among the 3 groups; histopathological fibrosis did not correlate with T1 values or markers of graft dysfunction. In pediatric heart transplant patients, native T1 values identify acute rejection requiring treatment and may identify graft dysfunction. CMR shows promise as an important tool for evaluation of cardiac grafts in children, with T1 imaging outperforming biopsy findings in the assessment of rejection. The online version contains supplementary material available at 10.1186/s12968-022-00875-z.
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影响因子：
17.1
作者：
De Vlaminck I;Valantine HA;Snyder TM;Strehl C;Cohen G;Luikart H;Neff NF;Okamoto J;Bernstein D;Weisshaar D;Quake SR;Khush KK
通讯作者：
Khush KK
DOI：
10.1186/s12968-016-0308-4
发表时间：
2016-11-30
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Haaf P;Garg P;Messroghli DR;Broadbent DA;Greenwood JP;Plein S
通讯作者：
Plein S
影响因子：
3.1
作者：
Dipchand, Anne I.
通讯作者：
Dipchand, Anne I.
DOI：
10.1016/j.healun.2011.11.019
发表时间：
2012-04
期刊：
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
影响因子：
--
作者：
Daly KP;Marshall AC;Vincent JA;Zuckerman WA;Hoffman TM;Canter CE;Blume ED;Bergersen L
通讯作者：
Bergersen L
影响因子：
2.1
作者：
Kobashigawa, Jon A.;Itagaki, Brandon K.;Fishbein, Michael C.
通讯作者：
Fishbein, Michael C.