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Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study
Author(s) -
Sahewalla Rini,
Sehgal Swati,
Blake Jennifer,
Aggarwal Sanjeev
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13632
Subject(s) - medicine , transplantation , heart transplantation , cardiology , speckle pattern , adaptation (eye) , speckle tracking echocardiography , bridge to transplantation , cardiac imaging , radiology , heart failure , ejection fraction , artificial intelligence , neuroscience , computer science , biology
Background Evolution of left ventricle (LV) function in the pediatric OHT population has not been well described. Our hypothesis was that, in children following OHT without any rejection, there would be progressive normalization of LV size and function over 2 years. Methods LV function was evaluated using STE and conventional echo parameters at five time points in pediatric OHT patients without any rejection in the first 2 years following OHT and normal controls. LV global peak systolic longitudinal strain (LVPLS) and strain rate, LV peak systolic radial and circumferential strain (LVRS and LVCS), and strain rate were analyzed. Results We had twenty two patients with median age at OHT of 1.27 years ( IQR 0.19, 5.6 years). The LVPLS (mean ± SD) was abnormal in the post‐OHT echocardiograms at 1 week (−12.4 ± 3.7) and 1 month (−13.9 ± 3.7) and significantly improved at 6 months (−15.8 ± 3.2), 1 year (−15.7 ± 3.1), and 2 years (−17.8 ± 2.8). However, LVPLS remained below the normal group even at 2 years following OHT (−21.3 ± 1.76). Conclusion In children following OHT, despite the absence of rejection, strain values are significantly impaired in the initial months, improve progressively over the first 2 years but remain abnormal compared with healthy controls.