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dc.contributor.authorSade, Leyla Elif
dc.contributor.authorHazirolan, Tuncay
dc.contributor.authorKozan, Hatice
dc.contributor.authorOzdemir, Handan
dc.contributor.authorHayran, Mutlu
dc.contributor.authorEroglu, Serpil
dc.contributor.authorPirat, Bahar
dc.contributor.authorSezgin, Atilla
dc.contributor.authorMuderrisoglu, Haldun
dc.date.accessioned2021-03-04T09:27:01Z
dc.date.available2021-03-04T09:27:01Z
dc.date.issued2019
dc.identifier.issn1936-878Xen_US
dc.identifier.urihttps://www.sciencedirect.com/science/article/pii/S1936878X18302249?via%3Dihub
dc.identifier.urihttp://hdl.handle.net/11727/5491
dc.description.abstractOBJECTIVES The aim of this study was to test the hypothesis that echocardiographic strain imaging, by tracking subtle alterations in myocardial function, and cardiac magnetic resonance T1 mapping, by quantifying tissue properties, are useful and complement each other to detect acute cellular rejection in heart transplant recipients. BACKGROUND Noninvasive alternatives to endomyocardial biopsy are highly desirable to monitor acute cellular rejection. METHODS Surveillance endomyocardial biopsies, catheterizations, and echocardiograms performed serially according to institutional protocol since transplantation were retrospectively reviewed. Sixteen-segment global longitudinal strain (GLS) and circumferential strain were measured before, during, and after the first rejection and at 2 time points for patients without rejection using Velocity Vector Imaging for the first part of the study. The second part, with cardiac magnetic resonance added to the protocol, served to validate previously derived strain cutoffs, examine the progression of strain over time, and to determine the accuracy of strain and T1 measurements to define acute cellular rejection. All tests were performed within 48 h. RESULTS Median time to first rejection (16 grade 1 rejection, 15 grade >= 2 rejection) was 3 months (interquartile range: 3 to 36 months) in 49 patients. GLS and global circumferential strain worsened significantly during grade 1 rejection and >= 2 rejection and were independent predictors of any rejection. In the second part of the study, T1 time >= 1,090 ms, extracellutar volume GLS >= 32%, GLS >-14%, and global circumferential strain >=-24% had 100% sensitivity and 100% negative predictive value to define grade >= 2 rejection with 70%, 63%, 55%, and 35% positive predictive values, respectively. The combination of GLS > 16% and T1 time >= 1,060 ms defined grade 1 rejection with 91% sensitivity and 92% negative predictive value. After successful treatment, T1 times decreased significantly. CONCLUSIONS T1 mapping and echocardiographic GLS can serve to guide endomyocardial biopsy selectively. (C) 2019 by the American College of Cardiology Foundation.en_US
dc.language.isoengen_US
dc.relation.isversionof10.1016/j.jcmg.2018.02.022en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectcardiac magnetic resonanceen_US
dc.subjectechocardiographyen_US
dc.subjectheart transplanten_US
dc.subjectstrainen_US
dc.subjectT1 mappingen_US
dc.titleT1 Mapping by Cardiac Magnetic Resonance and Multidimensional Speckle-Tracking Strain by Echocardiography for the Detection of Acute Cellular Rejection in Cardiac Allograft Recipientsen_US
dc.typearticleen_US
dc.relation.journalJACC-CARDIOVASCULAR IMAGINGen_US
dc.identifier.volume12en_US
dc.identifier.issue8en_US
dc.identifier.startpage1601en_US
dc.identifier.endpage1614en_US
dc.identifier.wos000478797900001en_US
dc.identifier.scopus2-s2.0-85045466371en_US
dc.contributor.pubmedID29680337en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergien_US
dc.contributor.researcherIDX-8540-2019en_US


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