Post-transplant surveillance for acute rejection and allograft vasculopathy by echocardiography: Usefulness of myocardial velocity and deformation imaging

Dandel, Michael; Hetzer, Roland

doi:10.1016/j.healun.2016.09.016

Cited by 41 publications

(22 citation statements)

References 66 publications

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“…[13][14][15][16][17][18][27][28][29][30][31] Several studies have shown that strain parameters are abnormally low during an acute rejection episode. [13][14][15][16][17][18][27][28][29][30][31] Several studies have shown that strain parameters are abnormally low during an acute rejection episode.…”

Section: Role Of Ste In the Diagnosis Of Rejection In Oht Patientsmentioning

confidence: 99%

“…LV STE has been shown to be useful for diagnosis of allograft rejection and coronary vasculopathy in both pediatrics and adults. [13][14][15][16][17][18][27][28][29][30][31] Several studies have shown that strain parameters are abnormally low during an acute rejection episode. 14,30,32 In a study by Sehgal…”

Section: Role Of Ste In the Diagnosis Of Rejection In Oht Patientsmentioning

confidence: 99%

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Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study

Sahewalla

Sehgal

Blake

et al. 2019

Clinical Transplantation

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Background: Evolution of left ventricle (LV) function in the pediatric OHT population has not been well described. Our hypothesis was that, in children following OHT without any rejection, there would be progressive normalization of LV size and function over 2 years.Methods: LV function was evaluated using STE and conventional echo parameters at five time points in pediatric OHT patients without any rejection in the first 2 years following OHT and normal controls. LV global peak systolic longitudinal strain (LVPLS) and strain rate, LV peak systolic radial and circumferential strain (LVRS and LVCS), and strain rate were analyzed.

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Section: Role Of Ste In the Diagnosis Of Rejection In Oht Patientsmentioning

confidence: 99%

Section: Role Of Ste In the Diagnosis Of Rejection In Oht Patientsmentioning

confidence: 99%

Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study

Sahewalla

Sehgal

Blake

et al. 2019

Clinical Transplantation

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“…22 Resting LVGLS has emerged as a robust parameter for detection of subclinical myocardial dysfunction. This traditionally involves echocardiographic assessment of systolic function by LVEF and diastolic function by trans-mitral diastolic doppler flow and in some centres resting RHC.…”

Section: Discussionmentioning

confidence: 99%

“…Outcome prediction in HTx patients by exercise haemodynamics 635 such as CAV and ACR is, at best, moderate. 22 Resting LVGLS has emerged as a robust parameter for detection of subclinical myocardial dysfunction. Its clinical utility is most valuable in patients with preserved LVEF like often seen in HTx patients even if they have advanced CAV and ACR.…”

Section: Discussionmentioning

confidence: 99%

“…Its clinical utility is most valuable in patients with preserved LVEF like often seen in HTx patients even if they have advanced CAV and ACR. 22 Importantly, LVGLS is strongly associated with CAV 6,15 and is more likely to be affected by ACR 5 than traditional echocardiographic parameters. Moreover, LVGLS had been demonstrated to possess great prognostic value after HTx, early 7,8 as well as late.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of exercise myocardial deformation and haemodynamics in long‐term heart‐transplanted patients

et al. 2019

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Aims The study evaluated exercise left ventricular global longitudinal strain (LVGLS) and invasive haemodynamics for major adverse cardiac events (MACE) prediction in heart‐transplanted (HTx) patients. Methods and results The study comprised 74 stable consecutive HTx patients who were followed at the Department of Cardiology, Aarhus University Hospital, Denmark, from August 2013 to January 2017. All patients were transplanted a minimum of 12 months before study entry and were included at the time of their routine annual coronary angiography. A symptom‐limited haemodynamic exercise test with simultaneous echocardiographic study was performed. The primary endpoint was MACE during follow‐up defined as heart failure hospitalization, treated rejection episodes, coronary event, or cardiac death. The median time since transplant was 5 years [1:12] and the median follow‐up was 1095 days [391;1506]. Thirty patients (41%) experienced MACE during follow‐up. Patients who suffered MACE had an impaired resting and peak exercise systolic function in form of a lower LV ejection fraction (Rest: 56 ± 12% vs. 65 ± 7%, P < 0.001; Peak 64 ± 13% vs. 72 ± 6%, P < 0.01) and LVGLS (Rest: 13 ± 4% vs. 16 ± 2%, P < 0.01; Peak: 15 ± 6% vs. 20 ± 4%, P = 0.0001) than patients without MACE episodes. In contrast, resting diastolic filling patterns were comparable between patients suffering from MACE and patients without MACE. At rest, pulmonary capillary wedge pressure (mPCWP) and cardiac index did not predict MACE, whereas increased right atrial pressure (mRAP) was associated with increased MACE risk. Patients with peak exercise mPCWP >23 mmHg [hazard ratio (HR) 2.5, 95% confidence interval (CI): 1.2–5.4], cardiac index <5.9 L/min/m2 (HR 2.7, 95% CI: 1.0–6.3), or mRAP >13 mmHg (HR 2.7, 95% CI: 1.1–6.3) had increased MACE risk. Patients with exercise‐induced LVGLS increase <3.5% and peak exercise cardiac index <5.9 L/min/m2 [HR 6.1 (95% CI: 2.2–17.1)] or mPCWP >23 mmHg [HR 6.1 (95% CI: 2.1–17.5)] or mRAP >13 mmHg [HR 7.5 (95% CI: 2.3–23.9)] had the highest MACE risk. Conclusions Resting haemodynamic parameters were poor MACE predictors in long‐term HTx patients. In contrast, peak exercise mPCWP, mRAP, and CI were significant MACE predictors. LVGLS both at rest and during exercise were significant MACE predictors, and the combined model with peak exercise LVGLS and peak exercise mPCWP, mRAP, and CI clearly identified high‐risk HTx patients in relation cardiovascular endpoints independently of time since HTx.

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Transplantation, Immunology, and Cell Biology

Santorelli

Kobayashi

2022

Surgical Critical Care and Emergency Surgery

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Post-transplant surveillance for acute rejection and allograft vasculopathy by echocardiography: Usefulness of myocardial velocity and deformation imaging

Cited by 41 publications

References 66 publications

Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study

Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study

Prognostic value of exercise myocardial deformation and haemodynamics in long‐term heart‐transplanted patients

Transplantation, Immunology, and Cell Biology

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