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Echocardiographic assessment of chamber size and ventricular function during the first year after heart transplantation

Ingvarsson, Annika LU orcid ; Werther Evaldsson, Anna LU orcid ; Waktare, Johan ; Braun, Oscar LU ; Jan Smith, Gustav ; Roijer, Anders LU ; Rådegran, Göran LU and Meurling, Carl LU (2021) In Clinical Physiology and Functional Imaging 41(4). p.355-365
Abstract

AIMS: Detecting changes in ventricular function after orthotopic heart transplantation (OHT) using transthoracic echocardiography (TTE) is important but interpretation of findings is complicated by lack of data on early graft adaptation. We sought to evaluate echocardiographic measures of ventricular size and function the first year following OHT including speckle tracking derived strain. We also aimed to compare echocardiographic findings to hemodynamic parameters obtained by right heart catheterization (RHC).

METHODS AND RESULTS: Fifty OHT patients were examined prospectively with TTE and RHC at 1, 6, and 12 months after OHT. Left ventricle (LV) was assessed with fractional shortening, ejection fraction, and systolic tissue... (More)

AIMS: Detecting changes in ventricular function after orthotopic heart transplantation (OHT) using transthoracic echocardiography (TTE) is important but interpretation of findings is complicated by lack of data on early graft adaptation. We sought to evaluate echocardiographic measures of ventricular size and function the first year following OHT including speckle tracking derived strain. We also aimed to compare echocardiographic findings to hemodynamic parameters obtained by right heart catheterization (RHC).

METHODS AND RESULTS: Fifty OHT patients were examined prospectively with TTE and RHC at 1, 6, and 12 months after OHT. Left ventricle (LV) was assessed with fractional shortening, ejection fraction, and systolic tissue velocities. Right ventricular (RV) evaluation included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S´) and fractional area change (FAC). LV global longitudinal and circumferential strain and RV global longitudinal strain (GLS) and RV lateral wall strain (RVfree) were analysed. No relevant changes occurred in LV echocardiographic parameters, whereas all measures of RV function improved significantly during follow up. There was an increase in TAPSE (12.4±3.3 mm to 14.4±4.3 mm, p<0.01), FAC (36±8% to 41±8%, p<0.01), RV GLS (-15.8±3.4% to -17.8±3.6%, p<0.01) and RVfree (-15.5±3.7% to -18.6±3.6%, p<0.001). Between one and twelve months pulmonary pressures decreased, whereas pulmonary vascular resistance did not.

CONCLUSION: Stable OHT recipients reached steady state regarding LV function one month after transplantation. In contrast, RV function displayed gradual improvement the first year following OHT, indicating delayed RV-adaptation as compared to the LV. Improved RV function-parameters were independent of invasively measured pulmonary pressures.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Physiology and Functional Imaging
volume
41
issue
4
pages
11 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:33830620
  • scopus:85105134043
ISSN
1475-0961
DOI
10.1111/cpf.12702
language
English
LU publication?
yes
id
5a10164e-80c6-4e87-a9c7-f929b3abf170
date added to LUP
2021-04-15 22:13:45
date last changed
2024-06-15 09:53:22
@article{5a10164e-80c6-4e87-a9c7-f929b3abf170,
  abstract     = {{<p>AIMS: Detecting changes in ventricular function after orthotopic heart transplantation (OHT) using transthoracic echocardiography (TTE) is important but interpretation of findings is complicated by lack of data on early graft adaptation. We sought to evaluate echocardiographic measures of ventricular size and function the first year following OHT including speckle tracking derived strain. We also aimed to compare echocardiographic findings to hemodynamic parameters obtained by right heart catheterization (RHC).</p><p>METHODS AND RESULTS: Fifty OHT patients were examined prospectively with TTE and RHC at 1, 6, and 12 months after OHT. Left ventricle (LV) was assessed with fractional shortening, ejection fraction, and systolic tissue velocities. Right ventricular (RV) evaluation included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S´) and fractional area change (FAC). LV global longitudinal and circumferential strain and RV global longitudinal strain (GLS) and RV lateral wall strain (RVfree) were analysed. No relevant changes occurred in LV echocardiographic parameters, whereas all measures of RV function improved significantly during follow up. There was an increase in TAPSE (12.4±3.3 mm to 14.4±4.3 mm, p&lt;0.01), FAC (36±8% to 41±8%, p&lt;0.01), RV GLS (-15.8±3.4% to -17.8±3.6%, p&lt;0.01) and RVfree (-15.5±3.7% to -18.6±3.6%, p&lt;0.001). Between one and twelve months pulmonary pressures decreased, whereas pulmonary vascular resistance did not.</p><p>CONCLUSION: Stable OHT recipients reached steady state regarding LV function one month after transplantation. In contrast, RV function displayed gradual improvement the first year following OHT, indicating delayed RV-adaptation as compared to the LV. Improved RV function-parameters were independent of invasively measured pulmonary pressures.</p>}},
  author       = {{Ingvarsson, Annika and Werther Evaldsson, Anna and Waktare, Johan and Braun, Oscar and Jan Smith, Gustav and Roijer, Anders and Rådegran, Göran and Meurling, Carl}},
  issn         = {{1475-0961}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{4}},
  pages        = {{355--365}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{Echocardiographic assessment of chamber size and ventricular function during the first year after heart transplantation}},
  url          = {{http://dx.doi.org/10.1111/cpf.12702}},
  doi          = {{10.1111/cpf.12702}},
  volume       = {{41}},
  year         = {{2021}},
}