Author + information
- Akhil Narang,
- John E. Blair,
- Victor Mor-Avi,
- Savitri Fedson,
- Nir Uriel,
- Roberto Lang and
- Amit Patel
Background: Abnormal myocardial perfusion reserve index (MPRi) is often noted after orthotopic heart transplant (OHT); however, its etiology is poorly understood. Our objective was to investigate the mechanism responsible for abnormal MPRi and to determine its functional consequences in OHT recipients.
Methods: Twenty OHT recipients underwent regadenoson stress cardiac magnetic resonance (sCMR) from which left ventricular (LV) ejection fraction (EF), burden of late gadolinium enhancement (LGE), and MPRi were determined. The occurrence of rejection from prior endomyocardial biopsies, the presence of coronary allograft vasculopathy (CAV) from coronary angiograms including TIMI frame counts, and abnormalities in global longitudinal strain (GLS) using echocardiography were also determined.
Results: Mean time from transplant to sCMR was 8.1±4.1 years. There was no relationship between MPRi and LVEF or LGE burden. There was no association between MPRi and episodes of rejection. MPRi was higher in patients with mild or no CAV versus those with moderate or severe CAV (0.51±0.09 versus 0.34±0.08, P=0.007). MPRi correlated moderately with TIMI frame counts (R=-0.68, P=0.0009) and with GLS (R=-0.68, P=0.001) (Figure).
Conclusions: Abnormal MPRi post-OHT is associated with CAV and subclinical LV dysfunction. It is not related to prior rejection, LVEF, or myocardial scar burden. Future studies will help determine whether sCMR is a useful non-invasive tool to identify OHT patients with CAV.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: MR Scar and Perfusion
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1244-202
- 2017 American College of Cardiology Foundation