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

Publication ,  Journal Article
Kazmirczak, F; Nijjar, PS; Zhang, L; Hughes, A; Chen, K-HA; Okasha, O; Martin, CM; Akçakaya, M; Farzaneh-Far, A; Shenoy, C
Published in: J Cardiovasc Magn Reson
January 24, 2019

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.

Duke Scholars

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Published In

J Cardiovasc Magn Reson

DOI

EISSN

1532-429X

Publication Date

January 24, 2019

Volume

21

Issue

1

Start / End Page

9

Location

England

Related Subject Headings

  • Vasodilator Agents
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Pyrazoles
  • Purines
  • Predictive Value of Tests
  • Percutaneous Coronary Intervention
  • Nuclear Medicine & Medical Imaging
 

Citation

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Kazmirczak, F., Nijjar, P. S., Zhang, L., Hughes, A., Chen, K.-H., Okasha, O., … Shenoy, C. (2019). Safety and prognostic value of regadenoson stress cardiovascular magnetic resonance imaging in heart transplant recipients. J Cardiovasc Magn Reson, 21(1), 9. https://doi.org/10.1186/s12968-018-0515-2
Kazmirczak, Felipe, Prabhjot S. Nijjar, Lei Zhang, Andrew Hughes, Ko-Hsuan Amy Chen, Osama Okasha, Cindy M. Martin, Mehmet Akçakaya, Afshin Farzaneh-Far, and Chetan Shenoy. “Safety and prognostic value of regadenoson stress cardiovascular magnetic resonance imaging in heart transplant recipients.J Cardiovasc Magn Reson 21, no. 1 (January 24, 2019): 9. https://doi.org/10.1186/s12968-018-0515-2.
Kazmirczak F, Nijjar PS, Zhang L, Hughes A, Chen K-HA, Okasha O, et al. Safety and prognostic value of regadenoson stress cardiovascular magnetic resonance imaging in heart transplant recipients. J Cardiovasc Magn Reson. 2019 Jan 24;21(1):9.
Kazmirczak, Felipe, et al. “Safety and prognostic value of regadenoson stress cardiovascular magnetic resonance imaging in heart transplant recipients.J Cardiovasc Magn Reson, vol. 21, no. 1, Jan. 2019, p. 9. Pubmed, doi:10.1186/s12968-018-0515-2.
Kazmirczak F, Nijjar PS, Zhang L, Hughes A, Chen K-HA, Okasha O, Martin CM, Akçakaya M, Farzaneh-Far A, Shenoy C. Safety and prognostic value of regadenoson stress cardiovascular magnetic resonance imaging in heart transplant recipients. J Cardiovasc Magn Reson. 2019 Jan 24;21(1):9.
Journal cover image

Published In

J Cardiovasc Magn Reson

DOI

EISSN

1532-429X

Publication Date

January 24, 2019

Volume

21

Issue

1

Start / End Page

9

Location

England

Related Subject Headings

  • Vasodilator Agents
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Pyrazoles
  • Purines
  • Predictive Value of Tests
  • Percutaneous Coronary Intervention
  • Nuclear Medicine & Medical Imaging