RT Journal Article
SR Electronic
A1 Podrouzkova, Helena
A1 Bedanova, Helena
A1 Tretina, Martin
A1 Korinek, Josef
A1 Stepanova, Radka
A1 Hruskova, Jana
A1 Nemec, Petr
A1 Konecny, Tomas
A1 Orban, Marek
T1 Decrease in longitudinal strain in heart transplant recipients is associated with rejection
JF Biomedical papers
YR 2015
VO 159
IS 4
SP 601
OP 606
DO 10.5507/bp.2015.020
UL https://biomed.papers.upol.cz/artkey/bio-201504-0014.php
AB Background: Around 20-40% of heart transplant patients experience moderate to severe rejection within the first year after heart transplantation. Endomyocardial biopsy (EMB) is a gold standard for diagnosing heart transplant rejection. There is a need for non-invasive alternatives that allow for early, safe and reliable diagnosis of acute graft rejection prior to the onset of clinical symptoms.
Aims: Our aim was to investigate the potential of speckle tracking derived strain analysis in the diagnosis of acute graft rejection.
Methods: Patients indicated for EMB consented to a trans-thoracic echocardiography examination (TTE) within 2 hours of the EMB. Of this cohort, those with at least 2 EMBs separated ≥ 1 week, and whose TTE could be analyzed for strain, were included. The relationship between strain and EMB results was evaluated.
Results: Of the 43 patients included (mean age 51.33±1.79, 67% male), 23 had findings of rejection identified on at least one EMB and at least one EMB without rejection for comparison. A significant deterioration in the longitudinal strain during rejection compared to non-rejection was found on apical 4-chamber views (-11.51±0.91 vs -13.48±0.96, P=0.025) and apical 2-chamber views (-11.84±0.78 vs -14.43±0.83, P=0.002). In the patients in whom no rejection was identified on either EBM, there was no significant change in longitudinal strain values at two different time points.
Conclusion: Worsening of longitudinal strain was associated with acute cellular rejection. Routine TTE-based strain analysis could help in early detection of cardiac rejection and timing of EMB.