Fusako Sera1, Tomoko S Kato2, Maryjane Farr1, Cesare Russo1, Zhezhen Jin3, Charles C Marboe4, Marco R Di Tullio1, Donna Mancini1, Shunichi Homma1. 1. Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York. 2. Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York. Electronic address: rinnko@sannet.ne.jp. 3. Department of Biostatistics, Columbia University Medical Center, New York, New York. 4. Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York.
Abstract
BACKGROUND: Noninvasive detection of rejection is a major objective in the management of heart transplant recipients. METHODS AND RESULTS: To investigate the utility of 2-dimensional speckle-tracking echocardiography (2D-STE), we retrospectively evaluated 160 sets of endomyocardial biopsies and echocardiograms from 59 asymptomatic heart transplant recipients. Conventional International Society for Heart and Lung Transplantation grade 1B or higher rejection was considered as treatment-requiring rejection (group R), whereas International Society for Heart and Lung Transplantation grade 0 or 1A was classified as group Non-R. Left ventricular global longitudinal strain (GLS), global circumferential strain, and global radial strain were assessed by 2D-STE. Twenty-five specimens were classified into group R. GLS was significantly associated with treatment-requiring rejection, whereas neither global radial strain nor global circumferential strain were. Lower GLS remained significantly associated with an increased risk of treatment-requiring rejection (odds ratio, 1.15 [95% CI, 1.01-1.30]; P=0.03) even in multivariate analysis. GLS with the absolute value of less than 14.8% showed sensitivity and specificity of 64% and 63%, respectively, for detection of treatment-requiring rejection. CONCLUSION: The 2D-STE-derived left ventricular GLS was associated with treatment-requiring rejection. Two-dimensional STE might be useful as a noninvasive supplemental tool for monitoring heart transplant recipients for possible treatment-requiring rejection.
BACKGROUND: Noninvasive detection of rejection is a major objective in the management of heart transplant recipients. METHODS AND RESULTS: To investigate the utility of 2-dimensional speckle-tracking echocardiography (2D-STE), we retrospectively evaluated 160 sets of endomyocardial biopsies and echocardiograms from 59 asymptomatic heart transplant recipients. Conventional International Society for Heart and Lung Transplantation grade 1B or higher rejection was considered as treatment-requiring rejection (group R), whereas International Society for Heart and Lung Transplantation grade 0 or 1A was classified as group Non-R. Left ventricular global longitudinal strain (GLS), global circumferential strain, and global radial strain were assessed by 2D-STE. Twenty-five specimens were classified into group R. GLS was significantly associated with treatment-requiring rejection, whereas neither global radial strain nor global circumferential strain were. Lower GLS remained significantly associated with an increased risk of treatment-requiring rejection (odds ratio, 1.15 [95% CI, 1.01-1.30]; P=0.03) even in multivariate analysis. GLS with the absolute value of less than 14.8% showed sensitivity and specificity of 64% and 63%, respectively, for detection of treatment-requiring rejection. CONCLUSION: The 2D-STE-derived left ventricular GLS was associated with treatment-requiring rejection. Two-dimensional STE might be useful as a noninvasive supplemental tool for monitoring heart transplant recipients for possible treatment-requiring rejection.
Authors: Nitin Chanana; Charlotte S Van Dorn; Melanie D Everitt; Hsin Yi Weng; Dylan V Miller; Shaji C Menon Journal: Pediatr Cardiol Date: 2017-02-04 Impact factor: 1.655
Authors: Richard J Boruta; Shelley D Miyamoto; Adel K Younoszai; Sonali S Patel; Bruce F Landeck Journal: Pediatr Cardiol Date: 2017-09-25 Impact factor: 1.655
Authors: Justin Godown; Debra A Dodd; Michael Stanley; Corey Havens; Meng Xu; James C Slaughter; David W Bearl; Jonathan H Soslow Journal: Pediatr Transplant Date: 2018-03-25
Authors: Akhil Narang; John E Blair; Mita B Patel; Victor Mor-Avi; Savitri E Fedson; Nir Uriel; Roberto M Lang; Amit R Patel Journal: Int J Cardiovasc Imaging Date: 2018-05-04 Impact factor: 2.357