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CMR\u2010derived ECV is a validated measure of DMF in native adult hearts that may predict heart failure and mortality. We explored associations of <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> with histologic myocardial fibrosis and clinical features after pediatric heart transplantation. Twenty\u2010five recipients (7.0\u00b16.3\u00a0years at transplant and 10.7\u00b16.5\u00a0years post\u2010transplant) were prospectively recruited for <jats:styled-content style=\"fixed-case\">CMR<\/jats:styled-content> and BNP measurement at the time of surveillance biopsy. All had normal ejection fractions and lacked heart failure symptoms. Fibrosis was quantified on biopsy after picrosirius red staining as CVF. <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> was quantified using contemporaneous hematocrit on basal and mid\u2010short\u2010axis slices. <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> was moderately correlated with <jats:styled-content style=\"fixed-case\">CVF<\/jats:styled-content> (<jats:italic>r<\/jats:italic>=.47; <jats:italic>P<\/jats:italic>=.019). We found no associations of <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> with hemodynamics, ischemic time, time since transplantation, or number of prior biopsies or acute rejections. Compared to healthy non\u2010transplant controls, there was no significant difference in <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> (25.1\u00b13.0 vs 23.7\u00b12.0%, <jats:italic>P<\/jats:italic>=.09). Log\u2010transformed <jats:styled-content style=\"fixed-case\">BNP<\/jats:styled-content> was correlated with <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> (recipients: <jats:italic>r<\/jats:italic>=.46, <jats:italic>P<\/jats:italic>=.02; recipients and controls: <jats:italic>r<\/jats:italic>=.45, <jats:italic>P<\/jats:italic>=.006). These findings suggest <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content> quantifies DMF and relates to biological indicators of cardiac function after pediatric heart transplantation.<\/jats:p>","DOI":"10.1111\/petr.12986","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T09:47:57Z","timestamp":1496396877000},"source":"Crossref","is-referenced-by-count":21,"title":["Diffuse myocardial fibrosis among healthy pediatric heart transplant recipients: Correlation of histology, cardiovascular magnetic resonance, and clinical phenotype"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4244-709X","authenticated-orcid":false,"given":"Brian","family":"Feingold","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Pittsburgh School of Medicine  Pittsburgh PA USA"},{"name":"Clinical and Translational Science University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia M.","family":"Salgado","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Reyes\u2010M\u00fagica","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey E.","family":"Drant","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Center UPMC Heart and Vascular Institute  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kellman","sequence":"additional","affiliation":[{"name":"National Heart Lung and Blood Institute National Institutes of Health  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik B.","family":"Schelbert","sequence":"additional","affiliation":[{"name":"Clinical and Translational Science University of Pittsburgh School of Medicine  Pittsburgh PA USA"},{"name":"Cardiovascular Magnetic Resonance Center UPMC Heart and Vascular Institute  Pittsburgh PA USA"},{"name":"Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy C.","family":"Wong","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Center UPMC Heart and Vascular Institute  Pittsburgh PA USA"},{"name":"Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.08.005"},{"key":"e_1_2_8_3_1","first-page":"319","article-title":"The postsurgical heart. 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