73 year old man with history of heart transplant for nonischemic cardiomyopathy in 2005, PPM placement, CKD with worsening TR and RV function referred for cardiac MRI to evaluate for rejection. Of note, given the patient's renal function no contrast was administered. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 58%, the LV end diastolic volume index is 76 ml/m2 (normal range: 74+/-15), the LVEDV is 130 ml (normal range 142+/-34), the LV end systolic volume index is 32 ml/m2 (normal range 25+/-9), the LVESV is 55 ml (normal range 47+/-19). There are no regional wall motion abnormalities present. Left AtriumThe left atrium is dilated consistent with previous transplant. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 48%, the RV end diastolic volume index is 63 ml/m2 (normal range 82+/-16), the RVEDV is 138 ml (normal range 142+/-31), the RV end systolic volume index is 33 ml/m2 (normal range 31+/-9), and the RVESV is 72 ml (normal range 54+/-17). There is a pacemaker lead noted within the RV.Right AtriumThe right atrium is dilated.Aortic ValveThe aortic valve is not well seen.Mitral ValveThe mitral valve opens widely and there is at least mild mitral regurgitation.Pulmonic ValveThe pulmonic valve is not well seenTricuspid ValveThe tricuspid valve opens widely. There is at least mild tricuspid regurgitation, which appears eccentrically directed but was not fully evaluated due to the abbreviated study.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is upper normal in size.Venous AnatomyThe SVC and IVC drain normally into the right atrium. There are transvenous device leads noted in the SVC.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere are sternotomy wires present. There is a left chest wall pacemaker with associated artifact. This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. Normal size LV with normal systolic function (EF 58%). 2. Normal size RV with mildly reduced systolic function (EF 48%).3. Biatrial dilation consistent with history of cardiac transplant. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.