Right Ventricular Dysfunction as an Echocardiographic Measure of Acute Rejection Following Heart Transplantation in Children

Noninvasive biomarkers of acute allograft rejection (AAR) following orthotopic heart transplantation (OHT) are needed. The aim of this study was to investigate the accuracy of echocardiographic (ECHO) right ventricular (RV) global functional and resistance indices in the detection of AAR. This retro...

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Bibliographic Details
Published in:Pediatric cardiology 2017-03, Vol.38 (3), p.442-447
Main Authors: Aggarwal, Sanjeev, Blake, Jennifer, Sehgal, Swati
Format: Article
Language:English
Subjects:
Cardiac Catheterization - adverse effects
Cardiac Surgery
Cardiology
Child
Child, Preschool
Children's furniture
Diastole
Echocardiography
Female
Graft Rejection - diagnostic imaging
Heart
Heart Defects, Congenital - complications
Heart Defects, Congenital - surgery
Heart Failure - surgery
Heart Transplantation
Heart Ventricles - physiopathology
Humans
Infant
Male
Medicine
Medicine & Public Health
Original Article
Retrospective Studies
ROC Curve
Systole
Transplantation
Tricuspid Valve Insufficiency - diagnostic imaging
Vascular Surgery
Ventricular Dysfunction, Right - diagnostic imaging
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Summary:Noninvasive biomarkers of acute allograft rejection (AAR) following orthotopic heart transplantation (OHT) are needed. The aim of this study was to investigate the accuracy of echocardiographic (ECHO) right ventricular (RV) global functional and resistance indices in the detection of AAR. This retrospective chart review included children with biopsy-proven AAR (grade ≥ 2R cellular or CD4 + antibody-mediated rejection) following OHT and an ECHO within 12 h of the biopsy. ECHO measures: (a) ratio of systolic to diastolic duration (S/D), (b) RV myocardial performance index (MPI) and (c) tricuspid regurgitant gradient to RV outflow tract velocity time integral ratio (TRG/VTI), were derived at baseline, during AAR and at two follow-ups. Sixteen patients [56% male, mean (SD) age at OHT 3.5 (4.3) years] had 16 AAR episodes. S/D (1.15 vs. 1.60, p  
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-016-1533-1