مورد إلكتروني
Cardiovascular Magnetic Resonance for Rejection Surveillance After Cardiac Transplantation.
| العنوان: | Cardiovascular Magnetic Resonance for Rejection Surveillance After Cardiac Transplantation. |
|---|---|
| المؤلفون: | Anthony, C, Imran, M, Pouliopoulos, J, Emmanuel, S, Iliff, J, Liu, Z, Moffat, K, Ru Qiu, M, McLean, CA, Stehning, C, Puntmann, V, Vassiliou, V, Ismail, TF, Gulati, A, Prasad, S, Graham, RM, McCrohon, J, Holloway, C, Kotlyar, E, Muthiah, K, Keogh, AM, Hayward, CS, Macdonald, PS, Jabbour, A |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) 2022-06-21 |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | BACKGROUND: Endomyocardial biopsy (EMB) is the gold standard method for surveillance of acute cardiac allograft rejection (ACAR) despite its invasive nature. Cardiovascular magnetic resonance (CMR)-based myocardial tissue characterization allows detection of myocarditis. The feasibility of CMR-based surveillance for ACAR-induced myocarditis in the first year after heart transplantation is currently undescribed. METHODS: CMR-based multiparametric mapping was initially assessed in a prospective cross-sectional fashion to establish agreement between CMR- and EMB-based ACAR and to determine CMR cutoff values between rejection grades. A prospective randomized noninferiority pilot study was then undertaken in adult orthotopic heart transplant recipients who were randomized at 4 weeks after orthotopic heart transplantation to either CMR- or EMB-based rejection surveillance. Clinical end points were assessed at 52 weeks. RESULTS: Four hundred one CMR studies and 354 EMB procedures were performed in 106 participants. Forty heart transplant recipients were randomized. CMR-based multiparametric assessment was highly reproducible and reliable at detecting ACAR (area under the curve, 0.92; sensitivity, 93%; specificity, 92%; negative predictive value, 99%) with greater specificity and negative predictive value than either T1 or T2 parametric CMR mapping alone. High-grade rejection occurred in similar numbers of patients in each randomized group (CMR, n=7; EMB, n=8; P=0.74). Despite similarities in immunosuppression requirements, kidney function, and mortality between groups, the rates of hospitalization (9 of 20 [45%] versus 18 of 20 [90%]; odds ratio, 0.091; P=0.006) and infection (7 of 20 [35%] versus 14 of 20 [70%]; odds ratio, 0.192; P=0,019) were lower in the CMR group. On 15 occasions (6%), patients who were randomized to the CMR arm underwent EMB for clarification or logistic reasons, representing a 94% reduction in the requirement for EMB-based surveillance. CONCLUSIONS |
| مصطلحات الفهرس: | 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences, 1117 Public Health and Health Services, Journal Article |
| URL: | Circulation 10.1161/CIRCULATIONAHA.121.057006 |
| الإتاحة: | Open access content. Open access content info:eu-repo/semantics/closedAccess |
| أرقام أخرى: | LT1 oai:opus.lib.uts.edu.au:10453/164051 Circulation, 2022, 145, (25), pp. 1811-1824 0009-7322 1524-4539 1355962475 |
| المصدر المساهم: | UNIV OF TECH, SYDNEY From OAIster®, provided by the OCLC Cooperative. |
| رقم الأكسشن: | edsoai.on1355962475 |
| قاعدة البيانات: | OAIster |
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