title: Frequency, time course, and possible causes of right ventricular systolic dysfunction after cardiac transplantation: a single center experience.
abstract: BACKGROUND
  The frequency and causes of right ventricular (RV) systolic dysfunction early after cardiac transplantation are not well defined.
  
  
  METHODS
  We investigated the prevalence and causes of RV dysfunction in 27 heart transplant recipients, as measured by lateral tricuspid annular plane excursion (TAPSE) and fractional area change (FAC) at a mean of 15 ± 11 days after transplant. Tissue Doppler imaging was used to assess systolic time velocity integral (TVI) of the RV basal free wall. A subset of 22 patients had follow-up TAPSE measurement at 406 ± 121 days.
  
  
  RESULTS
  RV systolic dysfunction, defined as TAPSE > 2 standard deviation (SD) below values in a control group, was present in 100% (27/27) of patients (P < 0.05). FAC was also significantly lower in patients compared with controls (P < 0.0001). TVI confirmed the presence of RV dysfunction in all 16 patients with both TAPSE and TVI (P < 0.05). Ischemic time (P = 0.017) and posttransplant tricuspid regurgitation (P = 0.024) were independent predictors of early RV dysfunction (r = 0.753). On follow-up, RV function improved in 15 of 22 patients but all patients remained with TAPSE > 2 SD below controls.
  
  
  CONCLUSIONS
  This study showed that 100% of patients had reduced RV function early after transplant. Two thirds of patients had partial recovery of RV function during the first year. In all patients, however, RV function remained significantly lower than in controls.
authors.affiliation: Department of Medicine of Indiana University Medical Center and the Krannert Institute of Cardiology, Indianapolis, Indiana, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Mastouri
authors.forename: Yasir
authors.initials: Y
authors.lastname: Batres
authors.forename: Adam
authors.initials: A
authors.lastname: Lenet
authors.forename: Irmina
authors.initials: I
authors.lastname: Gradus-Pizlo
authors.forename: Jacqueline
authors.initials: J
authors.lastname: O'Donnell
authors.forename: Harvey
authors.initials: H
authors.lastname: Feigenbaum
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Sawada
mesh_terms: D015984:Causality; D004452:Echocardiography / Q000706:statistics & numerical data; D005260:Female; D016027:Heart Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000453:epidemiology*