Document Detail

Non-invasive diagnostic of cardiac allograft vasculopathy by 31P magnetic resonance chemical shift imaging.
MedLine Citation:
PMID:  16343922     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary angiography is still the gold standard for the diagnosis of cardiac allograft vasculopathy (CAV) for which alternative non-invasive diagnostic approaches are currently investigated. In this study, we assessed whether 31P magnetic resonance chemical shift imaging can diagnose CAV by studying variations in cardiac high-energy phosphates in a population of adult heart transplant recipients. METHODS AND RESULTS: CAV was defined by coronary angiography as the presence of diffuse coronary irregularities with significant concentric narrowing on epicardial or distal coronary arteries. Eight patients with CAV (group A), and 18 patients without CAV (group B) were included in this study and compared to nine healthy volunteers (group C). Patients and volunteers underwent 31P three-dimensional chemical shift imaging to determine the ratio of phosphocreatine (PCr) and adenosine tri-phosphate (ATP). PCr/ATP was significantly lower in group A (1.51+/-0.50) than in groups B and C (1.98+/-0.53 (p=0.003) and 2.14+/-0.31 (p=0.001)), respectively. Time from transplant, number of episodes of acute rejection, and left ventricular ejection fraction (LVEF) were not significantly different between patient groups. A PCr/ATP value of 1.59 was the optimal cut-off value to predict CAV (specificity and sensitivity of 100% and 72%, respectively). CONCLUSION: Clinically, in vivo 31P chemical shift imaging is a promising, non-invasive method to detect the potential modifications of high-energy phosphates related to CAV and to better screen indications for coronary angiograms. This may be relevant for coronary angiography follow-up and adjustments of immunotherapy regimen.
Thierry Caus; Frank Kober; Pablo Marin; Annick Mouly-Bandini; Jacques Quilici; Dominique Métras; Patrick J Cozzone; Monique Bernard
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-12-15
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  29     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-26     Completed Date:  2006-03-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  45-9     Citation Subset:  IM    
Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR CNRS 6612, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France.
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MeSH Terms
Adenosine Triphosphate / metabolism
Coronary Disease / diagnosis*,  pathology
Coronary Vessels / pathology
Graft Rejection / diagnosis
Heart Transplantation / adverse effects*
Magnetic Resonance Spectroscopy / diagnostic use*,  methods
Phosphates / metabolism
Phosphocreatine / metabolism
Phosphorus Isotopes / diagnostic use
Stroke Volume / physiology
Time Factors
Reg. No./Substance:
0/Phosphates; 0/Phosphorus Isotopes; 56-65-5/Adenosine Triphosphate; 67-07-2/Phosphocreatine
Comment In:
Eur J Cardiothorac Surg. 2006 May;29(5):862-3; author reply 863-4   [PMID:  16520039 ]

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