title: Cardiac mechanics in heart transplant recipients with and without transplant vasculopathy.
abstract: Evaluation of cardiac mechanics in heart transplant recipients (HTR) is of paramount importance. Assessment of strain through echocardiography is suited to describe cardiac function and might allow characterizing patients with and without transplant vasculopathy (TVP) a risk factor of impaired organ function and rejection. For this study 41 HTR immediately after and 1-3 years after transplantation were examined in a retrospective approach with 2-dimensional speckle tracking echocardiography to assess longitudinal, radial and circumferential strain and strain rate. The cohort consists of 33 men and 8 women with a median age of 54 years (1st, 3rd; 45.7, 65.3) with seven cases diagnosed with TVP during follow-up, as diagnosed by coronary angiography. The overall cohort showed an improvement of global longitudinal strain from baseline to 1 and 3 years with -14.2% (-16.9, -12.3%) to -16.1% (-17.5, -14.3%) and -16.7% (-18, -13.7%), p = 0.036. For patients developing TVP, global longitudinal strain was not different from baseline up to the maximum of 3 years -16.6% (-16.7-13.8%) to -16.4% (-17.3, -14.7%) and -17.6% (-18.7, -16.9%) with p = 0.21. Radial strain and torsion showed a trend to decrease after transplantation with time. Circumferential strain remained stable in HTR but decreased in subjects with TVP. Longitudinal Strain and strain rate showed no relevant changes in HTR with and without TVP. Radial strain and torsion declined in HTR as well as TVP patients with time. Speckle tracking imaging is useful to assess organ function in HTR, however coronary angiography is still needed to rule out TVP.
authors.affiliation: Department of General and Interventional Cardiology, University Heart Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany.
authors.forename: Elvin
authors.initials: E
authors.lastname: Zengin
authors.forename: Dirk
authors.initials: D
authors.lastname: Westermann
authors.forename: Ulf
authors.initials: U
authors.lastname: Radunski
authors.forename: Francisco
authors.initials: F
authors.lastname: Ojeda
authors.forename: Kai
authors.initials: K
authors.lastname: Muellerleile
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.forename: Christoph
authors.initials: C
authors.lastname: Sinning
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013314:Stress, Mechanical; D013318:Stroke Volume; D013997:Time Factors; D054159:Torsion, Mechanical; D016896:Treatment Outcome; D016276:Ventricular Function / Q000187:drug effects
chemical_list: D007166:Immunosuppressive Agents