Two-Dimensional Speckle Tracking Echocardiography in Heart Transplant Patients: Two-Year Follow-Up of Right and Left Ventricular Function

Background Evolution of left and right ventricular (LV and RV) function after heart transplantation (HT) has not been well described. Our objective was to evaluate the evolution of echocardiographic parameters of both ventricles along the first 2 years after HT. Methods We followed 31 HT recipients...

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Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2016-05, Vol.33 (5), p.703-713
Main Authors: Moñivas Palomero, Vanessa, Mingo Santos, Susana, Goirigolzarri Artaza, Josebe, Rodriguez Gonzalez, Elena, Restrepo Córdoba, María Alejandra, Jiménez Sanchez, Diego, Rivero Arribas, Betsaida, Garcia Lunar, Inés, Mitroi, Cristina D., Sayago Silva, Ines, Cavero Gibanel, Miguel A., Gómez Bueno, Manuel, Alonso Pulpón, Luis A., Segovia Cubero, Javier
Format: Article
Language:English
Subjects:
acute rejection
Echocardiography - methods
Elasticity Imaging Techniques - methods
Female
Follow-Up Studies
Heart Failure - complications
Heart Failure - diagnostic imaging
Heart Failure - surgery
Heart Transplantation
Humans
Longitudinal Studies
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
speckle tracking
strain
Stroke Volume
Treatment Outcome
Ventricular Dysfunction - diagnostic imaging
Ventricular Dysfunction - etiology
Ventricular Dysfunction - prevention & control
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Summary:Background Evolution of left and right ventricular (LV and RV) function after heart transplantation (HT) has not been well described. Our objective was to evaluate the evolution of echocardiographic parameters of both ventricles along the first 2 years after HT. Methods We followed 31 HT recipients with serial echocardiograms for up to 2 years. Echocardiograms with AR ≥2R were excluded. We analyzed LV global longitudinal strain (LV GLS) by speckle tracking in 12 segments in four‐ and two‐chamber views and RV global longitudinal strain (RV GLS) in four‐chamber view. Control group included 25 healthy volunteers. Results Even though LVEF was preserved, LV GLS was reduced early post‐HT (−17.7 ± 3.0 in HT vs. −20.7 ± 2.8 in controls, P = 0.02), improving progressively until its complete normalization 2 years after HT (−20.0 ± 3.7 vs. −20.7 ± 2.8, P = 0.60). TAPSE was impaired in the early post‐HT period and increased progressively (11.9 ± 2.9 mm at baseline vs. 19.0 ± 3.6 mm at 2 years, P < 0.001). RV GLS rose during follow‐up as well (−17.4 ± 3.5 at baseline vs. −22.6 ± 3.3 at 2 years, P = 0.001), reaching normal values 1 year after HT. Conclusion In this series of HT recipients with uneventful postoperative course, LV and RV GLS values were significantly reduced early after HT and improved progressively until their complete normalization two and 1 year after HT, respectively. This is the first study to show a full recovery of LV and RV deformation parameters and offers “normal” strain values that, if confirmed in larger studies, could be useful for monitoring the evolution of HT recipients.
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.13169