Echocardiographic assessment of chamber size and ventricular function during the first year after heart transplantation

Ingvarsson, Annika; Evaldsson, Anna Werther; Waktare, Johan; Braun, Öscar; Smith, Gudmund J. W.; Roijer, Anders; Rådegran, Göran; Meurling, Carl

doi:10.1111/cpf.12702

Cited by 8 publications

(15 citation statements)

References 26 publications

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“…The authors could not explain the improvement in RV function parameters by changes in pulmonary pressures over time. 19 Similar findings regarding severely abnormal RV strain the first 3 months with improvement at 1 to 5 years follow up has also been reported by another group. 20 On the contrary, in another cohort, adaptation time of the RVfree was found to be close to normal 2 months after OHT and continue to increase during the first year.…”

Section: Normal Adaptation Following Orthotopic Heart Transplantationsupporting

confidence: 86%

“…It has previously been shown that LV function reach a steady state already 1 month after transplantation, whereas RV function continuously improve during the first year following OHT and is normalized at 12 months. The authors could not explain the improvement in RV function parameters by changes in pulmonary pressures over time 19 . Similar findings regarding severely abnormal RV strain the first 3 months with improvement at 1 to 5 years follow up has also been reported by another group 20 .…”

Section: Discussionsupporting

confidence: 67%

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Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation

et al. 2022

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Aims Patients awaiting orthotopic heart transplantation (OHT) can be bridged utilizing a left ventricular assist device (LVAD) that reduces left ventricular filling pressures, decreases pulmonary artery wedge pressure, and maintains adequate cardiac output. This study set out to examine the poorly investigated area of if and how pre-treatment with LVAD impacts right ventricular (RV) function following OHT. Methods and resultsWe prospectively evaluated 59 (LVAD n = 20) consecutive OHT patients. Transthoracic echocardiography (TTE) was performed in conjunction with right heart catheterization (RHC) at 1, 6, and 12 months after OHT. RV function TTE-parameters included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S0), fractional area change, two-dimensional RV global longitudinal strain and longitudinal strain from the RV lateral wall (RVfree). At 1 month after OHT, the LVAD group had significantly better longitudinal RV function than the non-LVAD group: TAPSE (15 ± 3 mm vs. 12 ± 2 mm, P < 0.001), RV global longitudinal strain (À19.8 ± 2.1% vs. À14.3 ± 2.8%, P < 0.001), and RVfree (À19.8 ± 2.3% vs. À14.1 ± 2.9%, P < 0.001). At this time point, pulmonary vascular resistance (PVR) was also lower [1.2 ± 0.4 Wood Units (WU) vs. 1.6 ± 0.6 WU, P < 0.05] in the LVAD group compared with the non-LVAD group. At 6 and 12 months, no difference was detected in any of the TTE and RHC measured parameters between the two groups. Between 1 and 12 months, all parameters of RV function improved significantly in the non-LVAD group but remained unaltered in the LVAD group. Conclusions Our results indicate that pre-treatment with LVAD decreases PVR and is associated with significantly better RV function early following OHT. During the first year following transplantation, RV function progressively improved in the non-LVAD group such that at 6 and 12 months, no difference in RV function was detected between the groups.

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Section: Normal Adaptation Following Orthotopic Heart Transplantationsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 67%

Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation

et al. 2022

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“…has previously shown that longitudinal shortening accounts for almost 80% of overall RV function in the normal RV. Post‐operatively and up to 1‐year post‐pericardiectomy, prior findings have consistently shown that RV function, as assessed by various echocardiographic measures, 7,10,12,15,16 including TAPSE, 13 after HTx is initially reduced, then increases in the first year following HTx. Our depiction of the trajectory of TAPSE over time post‐HTx is in accordance with, but also extends, these prior findings as we did not limit our analyses to 1‐year post‐HTx, but rather included the entire follow‐up period (median 6.7 years).…”

Section: Discussionmentioning

confidence: 90%

“…Additionally, RV functional parameters have been found to be associated with meaningful outcomes including mortality, rejection, CAV, and functional capacity 8,9,11,14,18 . However, only few of these studies 7,8,11,13 specifically investigated TAPSE as a measure of RV function. In contrast to the present study, these prior studies, examining TAPSE as a measure of RV function, were either carried out in the pediatric population, 7 or limited to 1‐year post‐HTx, 7,8,13 and none of the studies examined the relation between TAPSE and mortality 7,8,11,13 .…”

Section: Discussionmentioning

confidence: 99%

“…However, only few of these studies 7,8,11,13 specifically investigated TAPSE as a measure of RV function. In contrast to the present study, these prior studies, examining TAPSE as a measure of RV function, were either carried out in the pediatric population, 7 or limited to 1‐year post‐HTx, 7,8,13 and none of the studies examined the relation between TAPSE and mortality 7,8,11,13 . In the present study, we measured TAPSE in adult HTx recipients at any given time point post‐HTx and found significant associations between reduced TAPSE and mortality and CAV, but not ACR and CKD.…”

Section: Discussionmentioning

confidence: 99%

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Impact of serial measurements of tricuspid annular plane systolic excursion on mortality and morbidity after heart transplantation

Vishram-Nielsen

Nelson

Fan

et al. 2022

Clinical Transplantation

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The impact of right ventricular (RV) dysfunction on long‐term post‐HTx outcomes remains uncertain. We assessed the impact of serial measurements of Tricuspid Annular Plane Systolic Excursion (TAPSE) on post‐HTx mortality and morbidity. This two‐center retrospective cohort study included consecutive adult HTx recipients (2000–2017). We used multivariable extended hazard regression models to evaluate the association between TAPSE and left ventricular ejection fraction (LVEF), entered as time‐dependent variables, and all‐cause mortality, cardiac allograft vasculopathy (CAV), acute cellular rejection (ACR), and chronic kidney disease (CKD). TAPSE was modelled using cubic splines. We included 485 HTx recipients (9461 TAPSE measurements), median (25th‐ 75th percentile) 19 (10–27) mm; median age was 52 (41–59) years, and 71.3% were male. During a follow‐up of 6.7 (3.0–10.8) years, 92 patients died, 225 had ACR >2R, 234 CAV, and 91 CKD. By multivariable analysis, for each 1‐mm decrease in patients with a TAPSE value <15mm, mortality increased by 22% (P<.001). For the average HTx recipient with a TAPSE of 15mm, 10mm, and 6mm, 1‐year mortality was 3%, 7%, and 17%, and 5‐year mortality was 8%, 20%, and 43%, respectively. Reduced TAPSE was significantly associated with increased CAV but notACR and CKD. A decrease in TAPSE below 15mm represents clinically significant graft dysfunction, warranting close monitoring.

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Hypothermic oxygenated perfusion (HOPE) safely and effectively extends acceptable donor heart preservation times: Results of the Australian and New Zealand trial

McGiffin,

Kure,

Macdonald

et al. 2024

The Journal of Heart and Lung Transplantation

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Echocardiographic assessment of chamber size and ventricular function during the first year after heart transplantation

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 8 publications

References 26 publications

Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation

Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation

Impact of serial measurements of tricuspid annular plane systolic excursion on mortality and morbidity after heart transplantation

Hypothermic oxygenated perfusion (HOPE) safely and effectively extends acceptable donor heart preservation times: Results of the Australian and New Zealand trial

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