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Final Program


Program-At-A-Glance

Rapid Fire Session

Session: Rapid Fire Session 3: Pediatric/Non-CHD (Monitor 11)

Exploring ventricular filling dynamics by cardiac MRI in a young heart transplant population: a novel study

Friday, February 6, 2026
10:36 AM - 10:43 AM  
Location: Galapagos / Aruba / Ilhabela (2nd Lower Level)

    Presenting Author(s)

  • AB

    Amulya Buddhavarapu, MD

    Assistant Professor of Pediatrics
    Ohio State University
    Houston, Texas, United States

    • Primary Author(s)

  • AB

    Amulya Buddhavarapu, MD

    Assistant Professor of Pediatrics
    Ohio State University
    Houston, Texas, United States

    • Co-Author(s)

  • TC

    Thomas C. Casto, MD

    Pediatric Cardiologist
    Nationwide Children's Hospital
    Columbus, Ohio, United States

  • Marc Lee, MD

    Assistant Professor of Pediatrics
    Nationwide Children's Hospital
    Columbus, Ohio, United States

  • Hannah Jacobs, DO

    Advanced Noninvasive Cardiac Imager
    Nationwide Children's Hospital
    Columbus, Ohio, United States

  • MG

    Megan Gunsaulus, MD

    Physician, Pediatric Cardiology
    Nationwide Children's Hospital
    Columbus, Ohio, United States

  • Rachel Tonnis, MD

    Pediatric Advanced Cardiovascular Imaging Fellow
    Nationwide Children's Hospital and The Ohio State University
    Columbus, Ohio, United States

  • DN

    Deipanjan Nandi, MD, MSc

    Assistant Professor of Pediatrics
    Nationwide Children's Hospital, United States

  • Kan N. Hor, MD

    Director, Advanced Cardiovascular Imaging and Fellowship Program, Associate Division Chief for Research
    Nationwide Children's Hospital and The Ohio State University
    Columbus, OH, USA, Ohio, United States

Background: Non-invasive assessment of diastolic dysfunction in a transplanted heart remains challenging due to lack of established normative data and post-surgical variations in atrial geometry. Furthermore, studies have shown inherent ventricular stiffness of the donor heart that varies with time and elevated ventricular filling pressures by cardiac catheterization. Altered donor heart geometry and atrioventricular filling mechanics are worsened in the pediatric population due to a frequent donor-recipient mismatch in the dimensions, conferring conventional echocardiographic indices of diastolic function unreliable. We aimed to assess a semi-automated, rapid method of measuring ventricular filling dynamics by cardiac MRI in pediatric post-orthotopic heart transplant patients and assess their relationship with invasively measured ventricular filling pressures.

Methods: Seventy-two CMR studies were performed among 36 post-heart transplant (HT) patients, 15 female, aged 17y (IQR 12.5,20.1). LV and RV filling curves were generated across all phases of the cardiac cycles excluding basal and apical slices with volume-averaging and unclear delineation of myocardium. Trends of LV and RV function, end-diastolic volume (EDV), peak filling rate (PFR), time to peak filling rate (TPFR), and ratio of PFR/EDV were compared to a group of 11 healthy controls using Mann Whitney U-test (see table 1&2). ROC analyses were performed to predict high LV and RV end-diastolic pressures (EDP) measured at the most recent cardiac catheterization using extracted diastolic indices.

Results: The HT group had significantly lower indexed LV and RV EDV, LV PFR/EDV, RV TPFR and RV PFR/EDV compared to healthy controls (p< 0.01). HT group with history of coronary artery vasculopathy had significantly lower indexed LV EDV (p=0.03). ROC analysis showed an area under curve (AUC) of 0.743 for LVTPFR and 0.643 for indexed LV EDV in predicting LV EDP > 15mmHg, and AUC of 0.629 for indexed RV EDV in predicting RV EDP > 12mmHg.

Conclusion: Assessment of diastolic function in the transplanted heart using ventricular filling curves is feasible, reliable and not time-intensive when semi-automated techniques are employed. Prospective studies are needed to fill the knowledge gap towards their clinical significance in the post-HT population.

Demographics and Volumetric Characteristics of Post-Heart Transplantation (HT) Group and Healthy Control Group











































































 HT group (n=72)Median (IQR)Control group (n= 11)Median (IQR)p-value
Age (y)17 (12.5-20.9)14 (13-16)0.08
Female (%)15 (42%)1 (9%) 
Body Surface Area (m2)1.68 (1.38-1.92)1.69 (1.51-1.82)0.99
LV EDV indexed (mL/m2)68 (58-76)95 (91-100) < 0.01*
LV Cardiac Index (L/min/m2)3.8 (3.5-4.5)3.9 (3.6-4.4) 0.9
LV Ejection Fraction (%)60 (57-64)60 (55-64)0.7
RV EDV indexed (ml/m2) 57 (53-61)99 (92-107)  < 0.01*
RV Cardiac Index (L/min/m2) 3.8 (3.4-4.3)3.8 (3.6-4.6)0.57
RV Ejection Fraction (%) 47 (40-57)55 (51-58) 0.02*
LV EDP (mmHg)13 (11-16)   
RV EDP (mmHg)10 (8-12)  

Left Ventricle LV, End-Diastolic Volume EDV, Right Ventricle RV, End-Diastolic Pressure EDP.Comparison of Ventricular Filling Dynamics by CMR Between Post-Heart Transplantation (HT) Patients and Healthy Controls



















































 HT Group (n=72)Median (IQR)Control Group (n=11)p-value
Heart Rate95 (84-108)71 (56-78) < 0.01*
LV PFR377 (274-441)399 (305-488)0.48
LV TPFR129 (105-146)127 (111-146)0.9
LV PFR/EDV3.54 (2.9-4.2)2.72 (2.36-2.91) < 0.01*
RV PFR255 (173-331)211 (181-264)0.34
RV TPFR145 (105-184)99 (73-197) < 0.01*
 RV PFR/EDV2.32 (1.86-2.89)1.29 (1.08-1.91) < 0.01*

Left Ventricle LV, Peak Filling Rate PFR, Time to Peak Filling Rate TPFR, End-Diastolic Volume EDV, Right Ventricle RV.