Impact of Asymptomatic Acute Cellular Rejection on Left Ventricle Myocardial Function Evaluated by Means of Two-Dimensional Speckle Tracking Echocardiography in Heart Transplant Recipients.

Background Our objective was to evaluate the impact of asymptomatic acute cellular rejection ( ACR) in left ventricular myocardial strain in heart transplant ( HT) recipients by means of two-dimensional speckle tracking echocardiography (2 DSTE). Methods From September 1, 2009 to December 15, 2010 a...

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Publicado en:Echocardiography Vol. 32; no. 2; pp. 229 - 238
Autores principales: Ruiz Ortiz, Martín, Peña, María Luisa, Mesa, Dolores, Delgado, Mónica, Romo, Elías, Santisteban, Marta, Puentes, Miguel, López Granados, Amador, Castillo, Juan Carlos, Arizón, José María, Lezo, José Suárez
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Feb2015
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Impact of Asymptomatic Acute Cellular Rejection on Left Ventricle Myocardial Function Evaluated by Means of Two-Dimensional Speckle Tracking Echocardiography in Heart Transplant Recipients.
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          Ruiz Ortiz, Martín
          Peña, María Luisa
          Mesa, Dolores
          Delgado, Mónica
          Romo, Elías
          Santisteban, Marta
          Puentes, Miguel
          López Granados, Amador
          Castillo, Juan Carlos
          Arizón, José María
          Lezo, José Suárez
        affil: Cardiology Department, Reina Sofía University Hospital
      sug:
        subj:
          Heart Transplantation
          Graft Rejection Evaluation
          Heart Ventricle, Left Physiopathology
          Myocardial Diseases
          Echocardiography Methods
          Descriptive Statistics
          Human
          Random Sample
          Interrater Reliability
          One-Way Analysis of Variance
          T-Tests
          Mann-Whitney U Test
          Logistic Regression
          ROC Curve
          Data Analysis Software
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          Male
          Middle Age
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          Adult
          Odds Ratio
          Confidence Intervals
          Intrarater Reliability
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Female
          Male
      ab: Background Our objective was to evaluate the impact of asymptomatic acute cellular rejection ( ACR) in left ventricular myocardial strain in heart transplant ( HT) recipients by means of two-dimensional speckle tracking echocardiography (2 DSTE). Methods From September 1, 2009 to December 15, 2010 a conventional echocardiography and 2 DSTE exam was performed on all consecutive HT recipients in their first year posttransplantation within 3 hours of the surveillance endomyocardial biopsies, as well as on 14 healthy controls. The association of strain echocardiographic variables with different grades of ACR was investigated. Results Of the 78 studies performed 4 ± 3 months after HT in 20 patients, 32 studies were coincident with grade 0R rejection, 41 with grade 1R, and 5 with grade 2R. Significantly lower values of average radial strain were found with higher grades of ACR (29.1 ± 7.7%, 23.2 ± 8.5%, and 14.3 ± 8.8% for grades 0R, 1R, and 2R of ACR, P = 0.001). Average deformation was similar for controls versus transplanted patients, in the absence of acute rejection: radial 29.1 ± 10.0% versus 29.1 ± 7.7%, P = 0.98; circumferential −19.3 ± 3.2% versus −20.2 ± 5.9%, P = 0.62; and longitudinal −20.7 ± 4.1% versus −18.5 ± 5.4%, P = 0.19. An average radial strain <25% presented 100% sensitivity, 48% specificity, 6% positive predictive value, and 100% negative predictive value for the presence of 2R rejection (area under the curve 0.80, IC 95% 0.60-0.99, P = 0.048). Conclusion In this study, HT recipients showed significantly lower values of average radial left ventricle strain, evaluated by means of 2 DSTE, with the presence of ACR.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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