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and purpose Preliminary reports suggests that left atrial longitudinal strain (LALS) variables are a sensitive marker of acute cellular rejection (ACR) in heart transplant recipients (HTxR), discriminating between those studies without rejection and those with any grade of rejection. Intervendor variability is a concern in the widespread use of this technique. Our objective was to compare the LALS evaluated by two different softwares. Methods From September 2014 to October 2016 we performed, in 18 consecutive adult HTxR in their first year posttransplantation, serial echocardiographic exams within 3 hours of the routine surveillance endomyocardial biopsies (EMB), in a single centre. Peak average longitudinal strain, and strain rate were measured in the left atrium in the apical four chambers view in all studies, using both softwares, its association with the presence of ACR was investigated, and intervendor variability was evaluated. Results a total of 147 pairs of EMB and echo exams were performed, 65 with no rejection (grade 0R), 82 with any grade of ejection (grades 1R and 2R). Intraclass correlation coeficients for intervendor reproducibility for LALS and LALSR were 0.4 (95%CI 0.26 - 0.57) and 0.3 (95%CI -0.06 - 0.52) respectively. The number of segments evaluable by each software was significantly different. Association of LALS with rejection is shown in the table. Conclusions In this monocentric prospective study, left atrial longitudinal strain variables were found to be a sensitive marker of acute cellular rejection in heart transplant recipients. Although intervendor reproducibility was poor, these results were consistent between both software. Results Software n/N (%)* Variable No ACR ACR≥1 p value Siemens 114/147 (77.5) Peak atrial LS 19.4 ± 7.4 15.5 ± 6.3 0.006 114/147 (77.5) Peak atrial LSR 1.5 ± 0.4 1.3 ± 0.5 0.005 TomTec 131/147 (89.1) Peak atrial LS 19.1 ± 6.2 14.1 ± 5.4 &amp;lt;0.005 131/147 (89.1) Peal atrial LSR 1.0 ± 0.4 0.8 ± 0.3 &amp;lt;0.005 n: number of exams evaluable by each software. N: total numbers of exams. *p = 0.01 for comparison between the proportion of exams evaluable by each software.

P937 Left atrial longitudinal strain as a marker of acute cellular rejection in heart transplant recipients: impact of intervendor variability