Details

Autor(en) / Beteiligte

• Kato, Tomoko-Sugiyama
• Oda, Noboru
• Hashimura, Kazuhiko
• Hashimoto, Shuji
• Nakatani, Takeshi
• Ueda, Hatsue-Ishibashi
• Shishido, Toshiaki
• Komamura, Kazuo

Titel

Strain rate imaging would predict sub-clinical acute rejection in heart transplant recipients

Ist Teil von

• European journal of cardio-thoracic surgery, 2010-05, Vol.37 (5), p.1104-1110

Ort / Verlag

Oxford: Elsevier Science B.V

Erscheinungsjahr

2010

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Objective: Non-invasive diagnosis of rejection is a major objective in the management of heart transplant recipients. The ability of strain rate (SR) imaging on echocardiograms to detect rejection in heart transplant recipients was investigated. Methods: A total of 396 endomyocardial biopsies, right-heart catheterisation and echocardiograms were performed in 35 heart transplant recipients. Mean values of systolic strain (ɛsys), peak systolic SR (SRsys), and peak early diastolic SR (SRdia) obtained from eight left ventricular segments were calculated. Results: According to the conventional International Society for Heart and Lung Transplantation criteria, 351 biopsies showed a rejection grade (acute rejection, AR) of 0 or 1a (group AR−) whereas 45 biopsies showed a grade of 1b or higher (group AR+). The ɛsys, SRsys and SRdia were significantly different between group AR+ and group AR− (−20.7 ± 8.0 vs −32.6 ± 6.3%, p ≪ 0.0001, 2.5 ± 1.8 vs 3.6 ± 1.1/s, p ≪ 0.0001, and −1.9 ± 1.6 vs −3.5 ± 1.3/s, p ≪ 0.001, respectively). Multivariate analysis identified ɛsys (p ≪ 0.0001) as a strong predictor for group AR+, and ɛsys cut-off value of −27.4% was associated with a predictive accuracy of 82.3%. The combination of ɛsys and SRdia discriminated group AR+ from group AR− with a predictive accuracy of 84.8%. The pulmonary artery wedge pressure was higher in group AR+ than that in group AR− (7.4 ± 3.0 vs 9.4 ± 4.4 mmHg, p ≪ 0.05). Conclusion: SR imaging is of potential clinical value for monitoring acute rejection in heart transplant recipients.