Donor and Recipient Characteristics in Heart Transplantation Are Associated with Altered Myocardial Tissue Structure and Cardiac Function

Ryan S Dolan; Amir A Rahsepar; Julie Blaisdell; Roberto Sarnari; Kambiz Ghafourian; Jane E Wilcox; Sadiya S Khan; Esther E Vorovich; Jonathan D Rich; Clyde W Yancy; Allen S Anderson; James C Carr; Michael Markl

doi:10.1148/ryct.2019190009

Donor and Recipient Characteristics in Heart Transplantation Are Associated with Altered Myocardial Tissue Structure and Cardiac Function

Radiol Cardiothorac Imaging. 2019 Dec 19;1(5):e190009. doi: 10.1148/ryct.2019190009.

Affiliation

¹ Department of Radiology, Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (R.S.D., A.A.R., J.B., R.S., J.C.C., M.M.); Department of Cardiology, Northwestern University, Chicago, Ill (K.G., J.E.W., S.S.K., E.E.V., J.D.R., C.W.Y., A.S.A.); and Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, Ill (M.M.).

Abstract

Purpose: To use structure-function cardiac MRI in the evaluation of relationships between donor and heart transplantation (HTx) recipient characteristics and changes in cardiac tissue structure and function. HTx candidates and donor hearts are evaluated for donor-recipient matches to improve survival, but the impact of donor and recipient characteristics on changes in myocardial tissue and function in the transplanted heart is not fully understood.

Materials and methods: Cardiac MRI at 1.5 T was performed from August 2014 to June 2017 in 58 HTx recipients (mean age, 51.1 years ± 12.6 [standard deviation], 26 female patients) and included T2 mapping (to evaluate edematous and/or inflammatory changes), precontrast and postcontrast T1 mapping (allowing the calculation of extracellular volume fraction [ECV] to estimate interstitial expansion), and tissue phase mapping (allowing the calculation of myocardial velocities and twist). Donor and recipient demographics (age, sex, height, weight, and body mass index [BMI]) and comorbidities (hypertension, diabetes, and smoking history) were evaluated for relationships with cardiac MRI measures.

Results: Sex-influenced cardiac MRI measures of myocardial tissue and function are as follows: Female HTx recipients demonstrated increased precontrast T1 (P = .002) and reduced systolic peak long-axis velocities (P = .015). Increased age of the donor heart was associated with elevated T2 (r = 0.32; P < .05) and ECV (r = 0.47; P < .01), indicating increased edema and interstitial expansion, as well as impaired diastolic peak long-axis velocities (r = 0.41; P < .01). Recipient-donor differences in age, weight, and BMI were significantly associated with elevated ECV (r = 0.36-0.48; P < .05). Hypertension in donors resulted in increased ECV (31.0% ± 4.2 vs 26.0% ± 3.3; P = .001).

Conclusion: Donor and HTx recipient characteristics were significantly associated with cardiac MRI-derived measures of myocardial tissue structure and function.© RSNA, 2019.

2019 by the Radiological Society of North America, Inc.

Grants and funding

R01 HL117888/HL/NHLBI NIH HHS/United States