Safety and prognostic value of regadenoson stress cardiovascular magnetic resonance imaging in heart transplant recipients

Journal of Cardiovascular Magnetic Resonance

Felipe Kazmirczak¹  Ko-Hsuan Amy Chen¹  Cindy M. Martin¹  Prabhjot S. Nijjar¹  Osama Okasha¹  Chetan Shenoy¹  Lei Zhang²  Mehmet Akçakaya³  Afshin Farzaneh-Far⁴  Andrew Hughes⁵ 

[1] Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center;Clinical and Translational Science Institute, University of Minnesota;Department of Electrical and Computer Engineering and Center for Magnetic Resonance Research, University of Minnesota;Division of Cardiology, Department of Medicine, University of Illinois at Chicago;University of Minnesota Medical School;

关键词: Cardiovascular magnetic resonance;    Stress perfusion;    Vasodilator;    Regadenoson;    Safety;   

DOI  :  10.1186/s12968-018-0515-2

来源: DOAJ

【 摘 要 】

Abstract Background There is a critical need for non-invasive methods to detect coronary allograft vasculopathy and to risk stratify heart transplant recipients. Vasodilator stress testing using cardiovascular magnetic resonance imaging (CMR) is a promising technique for this purpose. We aimed to evaluate the safety and the prognostic value of regadenoson stress CMR in heart transplant recipients. Methods To evaluate the safety, we assessed adverse effects in a retrospective matched cohort study of consecutive heart transplant recipients who underwent regadenoson stress CMR matched in a 2:1 ratio to age- and gender-matched non-heart transplant patients. To evaluate the prognostic value, we compared the outcomes of patients with abnormal vs. normal regadenoson stress CMRs using a composite endpoint of myocardial infarction, percutaneous intervention, cardiac hospitalization, retransplantation or death. Results For the safety analysis, 234 regadenoson stress CMR studies were included - 78 performed in 57 heart transplant recipients and 156 performed in non-heart transplant patients. Those in heart transplant recipients were performed at a median of 2.74 years after transplantation. Thirty-four (44%) CMR studies were performed in the first two years after heart transplantation. There were no differences in the rates of adverse effects between heart transplant recipients and non-heart transplant patients. To study the prognostic value of regadenoson stress CMRs, 20 heart transplant recipients with abnormal regadenoson stress CMRs were compared to 37 with normal regadenoson stress CMRs. An abnormal regadenoson stress CMR was associated with a significantly higher incidence of the composite endpoint compared with a normal regadenoson stress CMR (3-year cumulative incidence estimates of 32.1% vs. 12.7%, p = 0.034). Conclusions Regadenoson stress CMR is safe and well tolerated in heart transplant recipients, with no incidence of sinus node dysfunction or high-degree atrioventricular block, including in the first two years after heart transplantation. An abnormal regadenoson stress CMR identifies heart transplant recipients at a higher risk for major adverse cardiovascular events.

【 授权许可】

Unknown