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Methods We enrolled 48 patients (mean age, 54.7 ± 14.6 years; 37 men) at various stages after HTx (median 9.88 yrs). All patients underwent standard CMR at 1.5 T, images were acquired with retrospective ECG gating and during repeated single breath-holds. Balanced steady-state free precession were used to obtain cine images (echo time/ repetition time, 1.6/3.2 ms; flip angle, 60°; pixel size, 2.4 × 1.4 mm, slice thickness 8 mm, gap 2 mm) in three long-axis planes and in contiguous short-axis slices. LGE images were acquired in matching short-axis and long axis planes starting 10 min after intravenous injection of gadolinium-DTPA (Schering, Berlin, Germany; 0.15 mmol/kg) and using a segmented inversion-recovery gradient echo sequence. The primary endpoint was a composite of first occurrence of major cardiovascular adverse events which required hospitalization (MACE): CV death, congestive heart failure, redo transplant, arrhythmias requiring hospitalization (high degree A-V block, sustained supraventricular tachyarrhythmias, sustained ventricular tachycardia, bradycardia requiring pace-maker implantation), coronary revascularization, the secondary endpoints were all-cause death and cardiovascular death. Survival of patients was estimated by Kaplan-Meier analysis, for each end point Cox multivariate models were constructed.

Prognostic impact of late gadolinium enhancement cardiac magnetic resonance in the risk stratification of heart transplant patients