Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation
(2025) In JHLT Open 9.- Abstract
Background: In healthy hearts, left ventricular atrioventricular plane displacement (LVAVPD) measured by cardiac magnetic resonance (CMR) contributes to ∼60% of stroke volume. LVAVPD has been shown to correlate with maximal cardiac output and exercise capacity and is an independent predictor of outcomes in patients with heart failure. We aimed to assess if longitudinal pumping is altered, if LVAVPD is associated with exercise capacity, and if any difference in longitudinal pumping could be explained by the presence of a right bundle branch block (RBBB) in heart-transplanted patients. Method: This single-center study included 34 heart-transplanted patients who had undergone CMR and a cardiopulmonary exercise test as part of a clinical... (More)
Background: In healthy hearts, left ventricular atrioventricular plane displacement (LVAVPD) measured by cardiac magnetic resonance (CMR) contributes to ∼60% of stroke volume. LVAVPD has been shown to correlate with maximal cardiac output and exercise capacity and is an independent predictor of outcomes in patients with heart failure. We aimed to assess if longitudinal pumping is altered, if LVAVPD is associated with exercise capacity, and if any difference in longitudinal pumping could be explained by the presence of a right bundle branch block (RBBB) in heart-transplanted patients. Method: This single-center study included 34 heart-transplanted patients who had undergone CMR and a cardiopulmonary exercise test as part of a clinical post-transplant surveillance program. Data was compared to 34 healthy sex- and age-matched controls. Results: Heart-transplanted patients had decreased LVAVPD (10.3 vs 13.7 mm, p < 0.01), lower longitudinal contribution (46% vs 53%, p < 0.01), and lower septal contribution (−3% vs 8%, p < 0.01) to stroke volume compared to controls. Furthermore, the lateral contribution was increased (44% vs 28%, p < 0.01) in the heart-transplanted patients. Longitudinal contribution to stroke volume was neither associated with exercise capacity (p = 0.20) nor cardiac output at rest (p = 0.62). There was no difference in LVAVPD in patients with and without RBBB (p = 0.81). Conclusion: Heart-transplanted patients have decreased left ventricular longitudinal function compared to healthy controls, in part compensated by an augmented lateral function. Longitudinal function is not associated with cardiac output at rest or exercise capacity in this patient group. Whether the altered pumping mechanics seen are associated with outcome remains to be investigated.
(Less)
- author
- Gjesdal, Grunde LU ; Székely, Anna LU ; Engblom, Henrik LU ; Arheden, Håkan LU ; Braun, Oscar LU and Steding-Ehrenborg, Katarina LU
- organization
- publishing date
- 2025-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac magnetic resonance imaging, Heart transplant, Left ventricular atrioventricular plane displacement, Longitudinal contribution to stroke volume, Longitudinal heart function
- in
- JHLT Open
- volume
- 9
- article number
- 100308
- publisher
- Elsevier
- external identifiers
-
- scopus:105010945219
- pmid:40606292
- ISSN
- 2950-1334
- DOI
- 10.1016/j.jhlto.2025.100308
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 International Society for Heart and Lung Transplantation
- id
- 70a77cd8-7183-41d1-b31d-734db22177b6
- date added to LUP
- 2025-11-13 14:58:48
- date last changed
- 2025-11-14 03:00:03
@article{70a77cd8-7183-41d1-b31d-734db22177b6,
abstract = {{<p>Background: In healthy hearts, left ventricular atrioventricular plane displacement (LVAVPD) measured by cardiac magnetic resonance (CMR) contributes to ∼60% of stroke volume. LVAVPD has been shown to correlate with maximal cardiac output and exercise capacity and is an independent predictor of outcomes in patients with heart failure. We aimed to assess if longitudinal pumping is altered, if LVAVPD is associated with exercise capacity, and if any difference in longitudinal pumping could be explained by the presence of a right bundle branch block (RBBB) in heart-transplanted patients. Method: This single-center study included 34 heart-transplanted patients who had undergone CMR and a cardiopulmonary exercise test as part of a clinical post-transplant surveillance program. Data was compared to 34 healthy sex- and age-matched controls. Results: Heart-transplanted patients had decreased LVAVPD (10.3 vs 13.7 mm, p < 0.01), lower longitudinal contribution (46% vs 53%, p < 0.01), and lower septal contribution (−3% vs 8%, p < 0.01) to stroke volume compared to controls. Furthermore, the lateral contribution was increased (44% vs 28%, p < 0.01) in the heart-transplanted patients. Longitudinal contribution to stroke volume was neither associated with exercise capacity (p = 0.20) nor cardiac output at rest (p = 0.62). There was no difference in LVAVPD in patients with and without RBBB (p = 0.81). Conclusion: Heart-transplanted patients have decreased left ventricular longitudinal function compared to healthy controls, in part compensated by an augmented lateral function. Longitudinal function is not associated with cardiac output at rest or exercise capacity in this patient group. Whether the altered pumping mechanics seen are associated with outcome remains to be investigated.</p>}},
author = {{Gjesdal, Grunde and Székely, Anna and Engblom, Henrik and Arheden, Håkan and Braun, Oscar and Steding-Ehrenborg, Katarina}},
issn = {{2950-1334}},
keywords = {{Cardiac magnetic resonance imaging; Heart transplant; Left ventricular atrioventricular plane displacement; Longitudinal contribution to stroke volume; Longitudinal heart function}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{JHLT Open}},
title = {{Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation}},
url = {{http://dx.doi.org/10.1016/j.jhlto.2025.100308}},
doi = {{10.1016/j.jhlto.2025.100308}},
volume = {{9}},
year = {{2025}},
}