@article{Pouliopoulos:2025:10.1016/j.jocmr.2025.102675,
author = {Pouliopoulos, J and Imran, M and Anthony, C and Kessler, C and Moffat, K and Qiu, MR and Stehning, C and Puntmann, V and Prasad, S and Graham, RM and McCrohon, J and Holloway, C and Kotlyar, E and Muthiah, K and Keogh, AM and Hayward, CS and Macdonald, PS and Jabbour, A},
doi = {10.1016/j.jocmr.2025.102675},
journal = {J Cardiovasc Magn Reson},
title = {Cardiovascular magnetic resonance feature tracking for rejection surveillance after cardiac transplantation.},
url = {http://dx.doi.org/10.1016/j.jocmr.2025.102675},
volume = {28},
year = {2025}
}

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TY  - JOUR
AB  - BACKGROUND: Endomyocardial biopsy (EMB) is the standard invasive method for monitoring acute cardiac allograft rejection (ACAR); however, non-invasive alternatives are increasingly proving to be dependable. OBJECTIVES: We aimed to identify and validate dependable cardiovascular magnetic resonance (CMR) strain indices for ACAR detection. METHODS: We analyzed 160 CMR scans, including long- and short-axis cines, as well as T1/T2 maps from 54 transplant recipients. Uniparametric and multiparametric models integrating left ventricular strain metrics and tissue characteristics were developed to classify histological rejection grades (0, 1 R, ≥2 R) and evaluate therapeutic response. RESULTS: Regression analysis using generalized linear mixed-models identified significant differences between rejection groups, with global radial strain (GRS) (z-value = 3.1, p = 0.002) and global circumferential strain (GCS) (z-value = 2.5 p<0.008) outperforming global longitudinal strain (GLS) in discriminating ≥2 R from 1 R rejection. Diagnostic performance for detecting ≥2 R rejection was excellent, particularly for GCS (AUC = 0.852, negative predictive value [NPV] = 98.3%) and GRS (AUC = 0.826, NPV = 95.8% (95.8/100)), with enhanced accuracy in the anterolateral mid-basal segments (AUC>0.886, NPV>97.9%). Strain metrics effectively monitored recovery post-therapy for ≥2 R rejection, showing significant improvements (GRS Δ24.5±7.1%, GCS Δ15.9±4.6%, GLS Δ27.4±11.8%, all p<0.02). Furthermore, as strained-based detection of ≥2 R rejection correlated with increases in edema detected using T1/T2 mapping (all p<0.001), integrating strain with T1/T2 mapping significantly enhanced diagnostic accuracy, with T2+GRS (AUC = 0.931, NPV = 98.2) and T1+T2+GCS (AUC = 0.943, NPV = 97.5) as the most effective models. CONCLUSION: Segmental CMR strain analysis demonstrates excellent diagn
AU  - Pouliopoulos,J
AU  - Imran,M
AU  - Anthony,C
AU  - Kessler,C
AU  - Moffat,K
AU  - Qiu,MR
AU  - Stehning,C
AU  - Puntmann,V
AU  - Prasad,S
AU  - Graham,RM
AU  - McCrohon,J
AU  - Holloway,C
AU  - Kotlyar,E
AU  - Muthiah,K
AU  - Keogh,AM
AU  - Hayward,CS
AU  - Macdonald,PS
AU  - Jabbour,A
DO  - 10.1016/j.jocmr.2025.102675
PY  - 2025///
TI  - Cardiovascular magnetic resonance feature tracking for rejection surveillance after cardiac transplantation.
T2  - J Cardiovasc Magn Reson
UR  - http://dx.doi.org/10.1016/j.jocmr.2025.102675
UR  - https://www.ncbi.nlm.nih.gov/pubmed/41453739
VL  - 28
ER  - 

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