Premium
Three‐Dimensional Speckle‐Tracking Echocardiographic Monitoring of Acute Rejection in Heart Transplant Recipients
Author(s) -
Du Guo-Qing,
Hsiung Ming-Chon,
Wu Yan,
Qu Shao-Hui,
Wei Jeng,
Yin Wei-Hsian,
Tian Jia-Wei
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.07013
Subject(s) - medicine , ejection fraction , cardiology , speckle tracking echocardiography , radial stress , heart transplantation , receiver operating characteristic , cutoff , endomyocardial biopsy , doppler echocardiography , transplantation , biopsy , heart failure , diastole , blood pressure , velocity vector , engineering , aerospace engineering , physics , quantum mechanics
Objectives This study assessed the use of 3‐dimensional (3D) speckle‐tracking echocardiography for noninvasive monitoring and diagnosis of acute rejection in heart transplant recipients. Methods Fifteen heart transplant recipients underwent 32 endomyocardial biopsies; echocardiography was performed within 3 hours before biopsy. Twenty‐four biopsies (acute rejection–negative group) showed grade 0 or 1A rejection, and 8 biopsies (acute rejection–positive group) showed grade 1B or higher rejection (based on the International Society for Heart and Lung Transplantation criteria). Two‐dimensional, M‐mode, pulsed Doppler, and tissue Doppler echocardiography were performed to assess conventional heart structure and function, and 3D full‐volume echocardiography was recorded and analyzed. Results Global peak longitudinal strain was significantly lower in the acute rejection–negative group compared to the positive group (mean ± SD, −7.38% ± 1.34% versus −10.88% ± 3.81%; P = .017). Differences in left ventricular global peak radial strain (28.79% ± 10.79% versus 24.32% ± 5.24%; P = .272), global peak circumferential strain (−12.16% ± 4.87% versus −12.61% ± 2.38%; P = .806), and ejection fraction (49.42% ± 12.17% versus 50.68% ± 7.26%; P = .824) between the negative and positive groups were not significant. Significant correlations were observed between the left ventricular ejection fraction and global peak longitudinal, global peak radial, and global peak circumferential ( r = −0.72; P < .001; r = 0.60; P < 0.001; and r = −0.69; P < 0.001, respectively). Receiver operating characteristic curve analysis showed that a global peak longitudinal strain cutoff value of less than −9.55% could predict grade 1B or higher rejection with sensitivity of 87.50% and specificity of 54.17%. Conclusions Three‐dimensional speckle‐tracking echocardiography–derived global peak longitudinal strain is a useful parameter for detecting acute rejection; thus, 3D speckle‐tracking echocardiography can monitor dynamic and acute rejection (≥1B) in heart transplant recipients.