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Impact of Asymptomatic Acute Cellular Rejection on Left Ventricle Myocardial Function Evaluated by Means of Two‐Dimensional Speckle Tracking Echocardiography in Heart Transplant Recipients
Author(s) -
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
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12623
Subject(s) - medicine , asymptomatic , speckle tracking echocardiography , cardiology , ventricle , radial stress , predictive value , heart transplantation , ventricular function , ejection fraction , heart failure , deformation (meteorology) , physics , meteorology
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 .