Coronary Flow Reserve Predicts Longitudinal Myocardial Deformation Capacity in Heart‐Transplanted Patients

Clemmensen, Tor Skibsted; Løgstrup, Brian Bridal; Eiskjær, Hans; Poulsen, Steen Hvitfeldt

doi:10.1111/echo.13123

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…Another main observation is a statistically significant correlation between CFVR and LVGLS (r = 0.4, p<0.0001), which is similar to that in a previous study (r = 0.8，P < 0.0001) [5]. Notably, the collinearity between LVGLS and CFVR cannot be ruled out strictly, which may affect the accuracy of the combined model.…”

Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 84%

Association of Left Atrial Metrics with Atrial Fibrillation Rehospitalization and Adverse Cardiovascular Outcomes in Patients with Nonvalvular Atrial Fibrillation following Index Hospitalization

Bhat

Gan

Chen

et al. 2021

Journal of the American Society of Echocardiography

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Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 84%

Association of Left Atrial Metrics with Atrial Fibrillation Rehospitalization and Adverse Cardiovascular Outcomes in Patients with Nonvalvular Atrial Fibrillation following Index Hospitalization

Bhat

Gan

Chen

et al. 2021

Journal of the American Society of Echocardiography

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“…CAC: coronary artery calcium; CAV: cardiac allograft vasculopathy; CCTA: cardiac computed tomography angiography; CMR: cardiac magnetic resonance; DS: dobutamine-stress ECD: echocardiography; GLS: global longitudinal strain: LVEF: left ventricular ejection fraction; MBF: myocardial blood flow; PET: positron emission tomography; SPECT: single-photon emission computed tomography; WMAs: wall motion abnormalities LV-GLS and the presence of CAV and coronary microvascular dysfunction (Fig. 3) [26][27][28]. Clemmensen et al found a statistically significant correlation, and a significant reduction of LV-GLS among patients with no and mild CAV (CAV 0 vs CAV 1 ), as well as a preserved LVEF even in presence of moderate-to-severe CAV [26].…”

Section: Wall Motion Abnormalitiesmentioning

confidence: 99%

The role of non-invasive imaging modalities in cardiac allograft vasculopathy: an updated focus on current evidences

et al. 2021

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Cardiac allograft vasculopathy (CAV) is an obliterative and diffuse form of vasculopathy affecting almost 50% of patients after 10 years from heart transplant and represents the most common cause of long-term cardiovascular mortality among heart transplant recipients. The gold standard diagnostic technique is still invasive coronary angiography, which however holds potential for complications, especially contrast-related kidney injury and procedure-related vascular lesions. Non-invasive and contrast-sparing imaging techniques have been advocated and investigated over the past decades, in order to identify those that could replace coronary angiography or at least reach comparable accuracy in CAV detection. In addition, they could help the clinician in defining optimal timing for invasive testing. This review attempts to examine the currently available non-invasive imaging techniques that may be used in the follow-up of heart transplant patients, spanning from echocardiography to nuclear imaging, cardiac magnetic resonance and cardiac computed tomography angiography, weighting their advantages and disadvantages.

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“…Similar to reduced MPR by vCMR, abnormal global longitudinal strain (GLS) derived from transthoracic echocardiography (TTE) has been recently shown to be associated with CAV and coronary microvascular dysfunction [15–17] in studies from a single group of investigators. Moreover, the same group has reported that decreased GLS is associated with repeated episodes of allograft rejection [18].…”

Section: Introductionmentioning

confidence: 99%

Myocardial perfusion reserve and global longitudinal strain as potential markers of coronary allograft vasculopathy in late-stage orthotopic heart transplantation

Narang

Blair

Patel

et al. 2018

Int J Cardiovasc Imaging

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Coronary allograft vasculopathy (CAV) is a major cause of mortality in late-stage orthotopic heart transplantation (OHT) patients. Recent evidence has shown that myocardial perfusion reserve (MPR) derived from vasodilator cardiovascular magnetic resonance imaging (vCMR) and global longitudinal strain (GLS) from transthoracic echocardiography (TTE) are useful to detect CAV. However, previous studies have not comprehensively addressed whether these parameters are confounded by allograft rejection, myocardial scar/fibrosis, or allograft dysfunction. Our aim was to determine whether changes in late post-OHT MPR and GLS are due to CAV or other confounding factors. Twenty OHT patients (time from transplant to vCMR was 8.1 ± 4.1 years) and 30 controls (10 healthy volunteers and 20 with prior myocardial infarction to provide perspective with regards to the severity of any abnormalities seen in post-OHT patients) underwent vasodilator vCMR from which MPR index (MPRi), left ventricular ejection fraction (LVEF), and burden of late gadolinium enhancement (LGE) were quantified. TTE was used to measure GLS. The presence of CAV was determined from invasive coronary angiograms using thrombolysis in myocardial infarction (TIMI) frame counts and grading severity per guidelines. Previous endomyocardial biopsies were reviewed to assess association with episodes of rejection. We examined the correlations between MPRi and GLS with markers of CAV, allograft function, scar/fibrosis, and rejection. MPRi was abnormal in post-OHT patients compared to both healthy volunteers and MI controls. While there was no relationship between MPRi or GLS and LVEF, episodes of rejection, or LGE burden, both MPRi and GLS were associated with TIMI frame counts and presence and severity of CAV. Additionally, MPRi correlated with GLS (R = 0.68, P = 0.0002). In conclusion, MPRi and GLS are abnormal in late-stage OHT and associated with CAV, but not related to allograft rejection, myocardial scar/fibrosis, or allograft dysfunction. Non-invasive monitoring of MPRi and GLS may be a useful strategy to detect CAV.

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Coronary Flow Reserve Predicts Longitudinal Myocardial Deformation Capacity in Heart‐Transplanted Patients

Cited by 12 publications

References 33 publications

Association of Left Atrial Metrics with Atrial Fibrillation Rehospitalization and Adverse Cardiovascular Outcomes in Patients with Nonvalvular Atrial Fibrillation following Index Hospitalization

Association of Left Atrial Metrics with Atrial Fibrillation Rehospitalization and Adverse Cardiovascular Outcomes in Patients with Nonvalvular Atrial Fibrillation following Index Hospitalization

The role of non-invasive imaging modalities in cardiac allograft vasculopathy: an updated focus on current evidences

Myocardial perfusion reserve and global longitudinal strain as potential markers of coronary allograft vasculopathy in late-stage orthotopic heart transplantation

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