Scientific Publications Database

Article Title: Diffuse Subepicardial Late Gadolinium Enhancement After Heart Transplant: A Potentially Ominous Finding
Authors: Almufleh, Aws; Garuba, Habibat; Mielniczuk, Lisa M.; Davies, Ross A.; Stadnick, Ellamae; Belanger, Eric; Dick, Alexander; Kozuszko, Stella; Ross, Heather J.; Chih, Sharon
Journal: CANADIAN JOURNAL OF CARDIOLOGY Volume 34 Issue 12
Date of Publication:2018
Abstract:
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging has prognostic utility in populations with cardiac disease, including heart transplant (HT) recipients. The etiology of specific LGE patterns and their correlation with outcomes after HT are unclear. Antibody-mediated rejection and cardiac allograft vasculopathy are major causes of death, and their evaluation remains challenging. We report identical diffuse subepicardial LGE in 2 highly allosensitized HT recipients who developed allograft failure. We postulate this LGE pattern may be related to antibody-mediated rejection and cardiac allograft vasculopathy, and portends poor outcomes. These cases illustrate a potential role of cardiac magnetic resonance for antibody-ediated rejection evaluation and risk stratification.