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Normal Reference Ranges for Transthoracic Echocardiography Following Heart Transplantation

Ingvarsson, Annika LU ; Werther Evaldsson, Anna LU ; Waktare, Johan; Nilsson, Johan LU ; Smith, Gustav J. LU ; Stagmo, Martin LU ; Roijer, Anders LU ; Rådegran, Göran LU and Meurling, Carl J. LU (2017) In Journal of the American Society of Echocardiography
Abstract

Background: Heart function following heart transplantation (HTx) is influenced by numerous factors. It is typically evaluated using transthoracic echocardiography, but reference values are currently unavailable for this context. The primary aim of the present study was to derive echocardiographic reference values for chamber size and function, including cardiac mechanics, in clinically stable HTx patients. Methods: The study enrolled 124 healthy HTx patients examined prospectively. Patients underwent comprehensive two-dimensional echocardiographic examinations according to contemporary guidelines. Results were compared with recognized reference values for healthy subjects. Results: Compared with guidelines, larger atrial dimensions were... (More)

Background: Heart function following heart transplantation (HTx) is influenced by numerous factors. It is typically evaluated using transthoracic echocardiography, but reference values are currently unavailable for this context. The primary aim of the present study was to derive echocardiographic reference values for chamber size and function, including cardiac mechanics, in clinically stable HTx patients. Methods: The study enrolled 124 healthy HTx patients examined prospectively. Patients underwent comprehensive two-dimensional echocardiographic examinations according to contemporary guidelines. Results were compared with recognized reference values for healthy subjects. Results: Compared with guidelines, larger atrial dimensions were seen in HTx patients. Left ventricular (LV) diastolic volume was smaller, and LV wall thickness was increased. With respect to LV function, both ejection fraction (62 ± 7%, P < .01) and global longitudinal strain (-16.5 ± 3.3%, P < .0001) were lower. All measures of right ventricular (RV) size were greater than reference values (P < .0001), and all measures of RV function were reduced (tricuspid annular plane systolic excursion 15 ± 4 mm [. P < .0001], RV systolic tissue Doppler velocity 10 ± 6 cm/sec [. P < .0001], fractional area change 40 ± 8% [. P < .0001], and RV free wall strain -16.9 ± 4.2% [. P < .0001]). Ejection fraction and LV global longitudinal strain were significantly lower in patients with previous rejection. Conclusion: The findings of this study indicate that the distribution of routinely used echocardiographic measures differs between stable HTx patients and healthy subjects. In particular, markedly larger RV and atrial volumes and mild reductions in both LV and RV longitudinal strain were evident. The observed differences could be clinically relevant in the assessment of HTx patients, and specific reference values should be applied in this context.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Allograft, Heart transplantation, Speckle-tracking, Strain, Two-dimensional echocardiography
in
Journal of the American Society of Echocardiography
publisher
Elsevier
external identifiers
  • scopus:85038843196
ISSN
0894-7317
DOI
10.1016/j.echo.2017.11.003
language
English
LU publication?
yes
id
e4b89f40-3b13-4607-9e22-98b8ac710534
date added to LUP
2018-01-10 14:38:01
date last changed
2018-01-11 03:00:02
@article{e4b89f40-3b13-4607-9e22-98b8ac710534,
  abstract     = {<p>Background: Heart function following heart transplantation (HTx) is influenced by numerous factors. It is typically evaluated using transthoracic echocardiography, but reference values are currently unavailable for this context. The primary aim of the present study was to derive echocardiographic reference values for chamber size and function, including cardiac mechanics, in clinically stable HTx patients. Methods: The study enrolled 124 healthy HTx patients examined prospectively. Patients underwent comprehensive two-dimensional echocardiographic examinations according to contemporary guidelines. Results were compared with recognized reference values for healthy subjects. Results: Compared with guidelines, larger atrial dimensions were seen in HTx patients. Left ventricular (LV) diastolic volume was smaller, and LV wall thickness was increased. With respect to LV function, both ejection fraction (62 ± 7%, P &lt; .01) and global longitudinal strain (-16.5 ± 3.3%, P &lt; .0001) were lower. All measures of right ventricular (RV) size were greater than reference values (P &lt; .0001), and all measures of RV function were reduced (tricuspid annular plane systolic excursion 15 ± 4 mm [. P &lt; .0001], RV systolic tissue Doppler velocity 10 ± 6 cm/sec [. P &lt; .0001], fractional area change 40 ± 8% [. P &lt; .0001], and RV free wall strain -16.9 ± 4.2% [. P &lt; .0001]). Ejection fraction and LV global longitudinal strain were significantly lower in patients with previous rejection. Conclusion: The findings of this study indicate that the distribution of routinely used echocardiographic measures differs between stable HTx patients and healthy subjects. In particular, markedly larger RV and atrial volumes and mild reductions in both LV and RV longitudinal strain were evident. The observed differences could be clinically relevant in the assessment of HTx patients, and specific reference values should be applied in this context.</p>},
  author       = {Ingvarsson, Annika and Werther Evaldsson, Anna and Waktare, Johan and Nilsson, Johan and Smith, Gustav J. and Stagmo, Martin and Roijer, Anders and Rådegran, Göran and Meurling, Carl J.},
  issn         = {0894-7317},
  keyword      = {Allograft,Heart transplantation,Speckle-tracking,Strain,Two-dimensional echocardiography},
  language     = {eng},
  publisher    = {Elsevier},
  series       = {Journal of the American Society of Echocardiography},
  title        = {Normal Reference Ranges for Transthoracic Echocardiography Following Heart Transplantation},
  url          = {http://dx.doi.org/10.1016/j.echo.2017.11.003},
  year         = {2017},
}