Current gold standard for surveillance of pediatric heart transplant (PHT) complications is invasive and imperfect. CMR allows non-invasive evaluation of myocardial structure and function. A retrospective review of 26 PHT who underwent regadenoson stress perfusion CMR with tissue characterization and 18 age-matched controls was performed. Global T1 and ECV were higher in PHT; as were biventricular volumes and cardiac output. Myocardial perfusion reserve index was lower in PHT. Structure-function correlations between LVEF and strain versus T2 were noted. T1, ECV were associated with clinical rejection scores. CMR comprehensively evaluates myocardial alterations in PHT.
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