title: Assessment of cardiac allograft systolic function by global longitudinal strain: From donor to recipient.
abstract: Cardiac allografts are routinely evaluated by left ventricular ejection fraction (LVEF) before and after transplantation. However, myocardial deformation analyses with LV global longitudinal strain (GLS) are more sensitive for detecting impaired LV myocardial systolic performance compared with LVEF.
  
  
  
  We analyzed echocardiograms in 34 heart donor-recipient pairs transplanted at Duke University from 2000 to 2013. Assessments of allograft LV systolic function by LVEF and/or LV GLS were performed on echocardiograms obtained pre-explanation in donors and serially in corresponding recipients.
  
  
  
  Donors had a median LVEF of 55% (25th, 75th percentile, 54% to 60%). Median donor LV GLS was -14.6% (-13.7 to -17.3%); LV GLS was abnormal (ie, >-16%) in 68% of donors. Post-transplantation, LV GLS was further impaired at 6 weeks (median -11.8%; -11.0 to -13.4%) and 3 months (median -11.4%; -10.3 to -13.9%) before recovering to pretransplant levels in follow-up. Median LVEF remained ≥50% throughout follow-up. We found no association between donor LV GLS and post-transplant outcomes, including all-cause hospitalization and mortality.
  
  
  
  GLS demonstrates allograft LV systolic dysfunction in donors and recipients not detected by LVEF. The clinical implications of subclinical allograft dysfunction detected by LV GLS require further study.
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.|Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Adam D
authors.identifier: 0000-0002-4679-2221
authors.initials: AD
authors.lastname: DeVore
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Fawaz
authors.initials: F
authors.lastname: Alenezi
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.|Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Arun
authors.initials: A
authors.lastname: Krishnamoorthy
authors.affiliation: Department of Cardiology, The Heart Centre, University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Ersboll
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Samsky
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Schulte
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.|Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Chetan B
authors.initials: CB
authors.lastname: Patel
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.|Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Rogers
authors.affiliation: Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Carmelo A
authors.initials: CA
authors.lastname: Milano
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.|Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Velazquez
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Michel G
authors.initials: MG
authors.lastname: Khouri
mesh_terms: D000328:Adult; D064591:Allografts; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D013318:Stroke Volume; D014019:Tissue Donors; D066027:Transplant Recipients; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult
keywords: donor selection; echocardiography; heart transplant; left ventricular function; strain