Serial changes of right ventricular function assessed by three-dimensional speckle-tracking echocardiography in clinically well adult heart transplantation patients

Li, Meng; Lv, Qing; Zhang, Yanting; Sun, Wei; Wu, Chun; Zhang, Yiwei; Zhu, Shuangshuang; Li, He; Dong, Nianguo; Li, Yuman; Zhang, Li; Xie, Mingxing

doi:10.1007/s10554-022-02778-7

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…Gradual improvements were seen in LVEF and RVFAC. Similar trends of LVEF and RVFAC recovery were found in adult HT patients without high degree of rejection 36,37 . Surprisingly, in this study, we found no significant change of S’ and TAPSE at different timepoints, which was contradictory with previous study by Harrington et al.…”

Section: Discussioncontrasting

confidence: 99%

“…Similar trends of LVEF and RVFAC recovery were found in adult HT patients without high degree of rejection. 36,37 Surprisingly, in this study, we found no significant change of S' and TAPSE at different timepoints, which was contradictory with previous study by Harrington et al that improvement of S' and TAPSE were found among rejection-free children and young adults over the first year after transplantation. 16 The inconsistency between studies may be a result [38][39][40] The decline in longitudinal shortening, even if the global RV function is preserved, suggests a compensatory increase in non-longitudinal shortening.…”

Section: Cardiac Functioncontrasting

confidence: 99%

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Echocardiographic assessment of pediatric heart transplantation: A single‐center experience in China

Xie,

Sun,

Zhu

et al. 2024

Echocardiography

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BackgroundPediatric heart transplant (HT) has become the standard of care for end‐stage heart failure in children worldwide. Serial echocardiographic evaluations of graft anatomy and function during follow‐up are crucial for post‐HT management. However, evolution of cardiac structure and function after pediatric HT has not been well described, especially during first year post‐HT. This study aimed to characterize the evolution of cardiac structure and function after pediatric HT and investigate the correlation between biventricular function with adverse clinical outcomes.MethodsA single‐center retrospective study of echocardiographic data obtained among 99 pediatric HT patients was conducted. Comprehensive echocardiographic examination was performed in all patients at 1‐, 3‐, 6‐, 9‐ and 12‐months post‐HT. We obtained structural, functional and hemodynamic parameters from both left‐ and right‐side heart, such as left ventricular stroke volume (LVSV), left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), etc. The cardiac evolution of pediatric HT patients during first post‐HT year was described and compared between different time points. We also explored the correlation between cardiac function and major adverse transplant events (MATEs).Results1) Evolution of left heart parameters: left atrial length, mitral E velocity, E/A ratio, LVSV and LVEF significantly increased while mitral A velocity significantly decreased over the first year after HT (P < .05). Compared with 1 month after HT, interventricular septum (IVS) and left ventricular posterior wall (LVPW) decreased at 3 months but increased afterwards. (2) Evolution of right heart parameters: right ventricular base diameter and mid‐diameter; right ventricular length diameter, tricuspid E velocity, E/A ratio, tricuspid annular velocity e’ at free wall, and RVFAC increased, while tricuspid A velocity decreased over the first year after HT (P < .05). (3) Univariate logistic regression model suggests that biventricular function parameters at 1‐year post‐HT (LVEF, RVFAC, tricuspid annular plane systolic excursion and tricuspid lateral annular systolic velocity) were associated with MATEs.ConclusionGradual improvement of LV and RV function was seen in pediatric HT patients within the first year. Biventricular function parameters associated with MATEs. The results of this study pave way for designing larger and longer follow‐up of this population, potentially aiming at using multiparameter echocardiographic prediction of adverse events.

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Section: Discussioncontrasting

confidence: 99%

Section: Cardiac Functioncontrasting

confidence: 99%

Echocardiographic assessment of pediatric heart transplantation: A single‐center experience in China

Xie,

Sun,

Zhu

et al. 2024

Echocardiography

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“…[2][3][4] We excluded CMRs performed during the first year after heart transplantation because cardiac function, particularly of the RV, could be abnormal in this period due to postoperative changes and typically resolves within the first year. [7][8][9][10] We also excluded patients who had acute rejection at the time of the CMR or within 1 month before or after the CMR. Thus, we included asymptomatic heart transplant recipients in the stable phase after transplantation, which we defined as starting at least 1 year after transplantation.…”

Section: Study Cohortmentioning

confidence: 99%

Right Ventricular Function on Cardiovascular Magnetic Resonance Imaging and Long-Term Outcomes in Stable Heart Transplant Recipients

Barrett,

Bawaskar,

Hughes

et al. 2024

Circ: Cardiovascular Imaging

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BACKGROUND: In heart transplant recipients, right ventricular (RV) dysfunction may occur for a variety of reasons. Whether RV dysfunction in the stable phase after heart transplantation is associated with long-term adverse outcomes is unknown. We aimed to determine the long-term prognostic significance of RV dysfunction identified on cardiovascular magnetic resonance imaging (CMR) at least 1 year after heart transplantation. METHODS: In consecutive heart transplant recipients who underwent CMR for surveillance, we assessed 2 CMR measures of RV function: RV ejection fraction and RV global longitudinal strain (RVGLS). We investigated associations between RV dysfunction and a composite end point of death or major adverse cardiac events, including retransplantation, nonfatal myocardial infarction, coronary revascularization, and heart failure hospitalization. RESULTS: A total of 257 heart transplant recipients (median age, 59 years; 75% men) who had CMR at a median of 4.3 years after heart transplantation were included. Over a median follow-up of 4.4 years after the CMR, 108 recipients experienced death or major adverse cardiac events. In a multivariable Cox regression analysis adjusted for age, time since transplantation, indication for transplantation, cardiac allograft vasculopathy, history of rejection, and CMR covariates, RV ejection fraction was not associated with the composite end point, but RVGLS was independently associated with the composite end point with a hazard ratio of 1.08 per 1% worsening in RVGLS ([95% CI, 1.00–1.17]; P =0.046). RVGLS provided incremental prognostic value over other variables in multivariable analyses. The association was replicated in subgroups of recipients with normal RV ejection fraction and recipients with late gadolinium enhancement imaging. A similar association was seen with a composite end point of cardiovascular death or major adverse cardiac events. CONCLUSIONS: CMR feature tracking–derived RVGLS assessed at least 1 year after heart transplantation was independently associated with the long-term risk of death or major adverse cardiac events. Future studies should investigate its role in guiding clinical decision-making in heart transplant recipients.

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“…The use of immunosuppressive drugs has made diabetes, hypertension, and renal dysfunction frequent comorbidities following transplantation. The drugs adopted for long-term management of cardiac transplantation may present an important factor affecting long-term RV myocardial function post-HT [ 58 ]. Therefore, assessment of RV function is critical.…”

Section: Ste-derived Rv Strain In Ht Patientsmentioning

confidence: 99%

“…They further demonstrated that RVFWLS of HT patients remained lower than the control, even by 12 months post-HT. The work indicated that 3D-STE may provide a suitable method for the follow-up of RV systolic function in HT patients, and demonstrated that the aggressive treatment may play an important role in affecting the performance of the right ventricle in HT patients [ 58 ]. Like 2D-STE, 3D-STE has also been applied to reveal subclinical impaired RV function in children and young adults without acute rejection.…”

Section: Ste-derived Rv Strain In Ht Patientsmentioning

confidence: 99%

Speckle-Tracking Echocardiography in Right Ventricular Function of Clinically Well Patients with Heart Transplantation

Ji,

Zhang,

Xie

et al. 2024

Diagnostics

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Heart transplantation (HT) is the mainstream therapy for end-stage heart disease. However, the cardiac graft function can be affected by several factors. It is important to monitor HT patients for signs of graft dysfunction. Transthoracic echocardiography is a simple, first-line, and non-invasive method for the assessment of cardiac function. The emerging speckle-tracking echocardiography (STE) could quickly and easily provide additive information over traditional echocardiography. STE longitudinal deformation parameters are markers of early impairment of ventricular function. Although once called the “forgotten ventricle”, right ventricular (RV) assessment has gained attention in recent years. This review highlights the potentially favorable role of STE in assessing RV systolic function in clinically well HT patients.

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Serial changes of right ventricular function assessed by three-dimensional speckle-tracking echocardiography in clinically well adult heart transplantation patients

Cited by 6 publications

References 29 publications

Echocardiographic assessment of pediatric heart transplantation: A single‐center experience in China

Echocardiographic assessment of pediatric heart transplantation: A single‐center experience in China

Right Ventricular Function on Cardiovascular Magnetic Resonance Imaging and Long-Term Outcomes in Stable Heart Transplant Recipients

Speckle-Tracking Echocardiography in Right Ventricular Function of Clinically Well Patients with Heart Transplantation

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