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Diffuse myocardial fibrosis among healthy pediatric heart transplant recipients: Correlation of histology, cardiovascular magnetic resonance, and clinical phenotype
Author(s) -
Feingold Brian,
Salgado Cláudia M.,
ReyesMúgica Miguel,
Drant Stacey E.,
Miller Susan A.,
Kennedy Mark,
Kellman Peter,
Schelbert Erik B.,
Wong Timothy C.
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12986
Subject(s) - medicine , cardiology , heart transplantation , heart failure , transplantation , fibrosis , myocardial fibrosis , ejection fraction , biopsy , cystic fibrosis , magnetic resonance imaging , pathology , radiology
Fibrosis is commonly described in heart allografts lost late after transplantation. CMR‐derived ECV is a validated measure of DMF in native adult hearts that may predict heart failure and mortality. We explored associations of ECV with histologic myocardial fibrosis and clinical features after pediatric heart transplantation. Twenty‐five recipients (7.0±6.3 years at transplant and 10.7±6.5 years post‐transplant) were prospectively recruited for CMR and BNP measurement at the time of surveillance biopsy. All had normal ejection fractions and lacked heart failure symptoms. Fibrosis was quantified on biopsy after picrosirius red staining as CVF. ECV was quantified using contemporaneous hematocrit on basal and mid‐short‐axis slices. ECV was moderately correlated with CVF ( r =.47; P =.019). We found no associations of ECV with hemodynamics, ischemic time, time since transplantation, or number of prior biopsies or acute rejections. Compared to healthy non‐transplant controls, there was no significant difference in ECV (25.1±3.0 vs 23.7±2.0%, P =.09). Log‐transformed BNP was correlated with ECV (recipients: r =.46, P =.02; recipients and controls: r =.45, P =.006). These findings suggest ECV quantifies DMF and relates to biological indicators of cardiac function after pediatric heart transplantation.