{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:29:46Z","timestamp":1790508586249,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Restrictive cardiac allograft physiology (RCP) is associated with poor prognosis following heart transplantation (HT). While cardiac magnetic resonance (CMR) is useful for evaluating HT recipients, its utility for RCP assessment remains unknown. This study aimed to investigate the diagnostic and prognostic value of CMR in patients with RCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010five HT recipients (median age: 54 [interquartile range (IQR), 40\u201363] years; 33.3% female) who underwent contrast\u2010enhanced CMR between 2015 and 2023 were included. Patients were grouped by RCP status (RCP\n                      <jats:sup>+<\/jats:sup>\n                      group,\n                      <jats:italic>n<\/jats:italic>\n                      = 30; and RCP\n                      <jats:sup>\u2212<\/jats:sup>\n                      group,\n                      <jats:italic>n<\/jats:italic>\n                      = 45). RCP was defined according to the International Society for Heart and Lung Transplantation guidelines. The primary endpoints were all\u2010cause mortality or redo HT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median HT\u2010to\u2010CMR time was 4.6 (IQR, 1.2\u201311.0) years. Compared to that of the RCP\n                      <jats:sup>\u2212<\/jats:sup>\n                      group, the RCP\n                      <jats:sup>+<\/jats:sup>\n                      group exhibited significantly higher myocardial T2 (53.1 \u00b1 7.5\u00a0vs. 49.7 \u00b1 5.7\u00a0ms;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.035) and extracellular volume fraction (ECV) (33.4 \u00b1 6.8%\u00a0vs. 28.6 \u00b1 6.1%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003) values. Multivariate logistic regression analyses revealed an independent association between ECV and RCP (odds ratio = 1.11; 95% CI: 1.02\u20131.23;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.032). The area under the receiver operating characteristic curve for ECV was 0.73, with 60.7% sensitivity and 83.3% specificity at a cutoff value of 31.5%. After ECV\u2010dependent stratification of patients with RCP, Kaplan\u2013Meier analysis demonstrated significantly higher incidences of primary endpoints in the ECV \u2265 31.5% subgroup than in the ECV &lt; 31.5% subgroup (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CMR\u2010derived myocardial ECV provides both diagnostic and prognostic value in patients with RCP and may potentially help guide the timing for consideration of re\u2010HT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70319","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T15:09:44Z","timestamp":1758208184000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic and Prognostic Value of Myocardial Extracellular Volume Fraction Assessed Using Cardiovascular Magnetic Resonance in Patients With Restrictive Cardiac Allograft Physiology"],"prefix":"10.1111","volume":"39","author":[{"given":"Masaki","family":"Tsuji","sequence":"first","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"},{"name":"Department of Cardiovascular Medicine Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-2691","authenticated-orcid":false,"given":"Michelle M.","family":"Kittleson","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0507-2412","authenticated-orcid":false,"given":"Evan P.","family":"Kransdorf","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriana P.","family":"Nikolova","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3024-9563","authenticated-orcid":false,"given":"Lily K.","family":"Stern","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mason","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon A.","family":"Kobashigawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Smidt Heart Institute, Cedars\u2010Sinai Medical Center  Los Angeles 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