Increased myocardial performance index by echocardiography correlates with biopsy-proven rejection in pediatric heart transplant recipients

Leonard, Glenn T.; Fricker, F. Jay; Pruett, Debra; Schowengerdt, Kenneth O.

doi:10.1016/s1053-2498(01)00460-0

Cited by 1 publication

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“…Previous efforts using conventional echocardiography for this purpose have not been considered broadly acceptable among HT physicians. [35][36][37] Further studies are needed to investigate whether the higher sensitivity of PW-TDI compared with conventional echocardiography in detecting functional changes can be used to develop criteria for defining a nonrejection echocardiogram with high predictive accuracy as to allow fewer routine biopsies in pediatric recipients. 38 This may be particularly relevant in the current era because the frequency of rejection and thus the yield of routinely performed biopsies for detecting rejection has decreased compared with earlier eras.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Allograft Function During the First Year after Transplantation in Rejection-Free Children and Young Adults

Lunze

Colan

Gauvreau

et al. 2012

Circ: Cardiovascular Imaging

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Background-Allograft dysfunction is a common finding early after heart transplant (HT). We sought to assess the recovery of left (LV) and right ventricular (RV) function during the first year after HT in children and young adults using pulsedwave tissue Doppler imaging. Methods and Results-We analyzed serially performed echocardiography in 44 pediatric HT recipients (median age: 7.3 years at HT) who remained rejection-free during the first year post-transplant. Age-based normative values for systolic (S′), early-diastolic (E′), and late-diastolic (A′) velocities obtained using pulsed-wave tissue Doppler imaging in 380 healthy children were used to transform patient data into z scores. Pulsed-wave tissue Doppler imaging studies ≤10 days post-HT demonstrated biventricular systolic and diastolic dysfunction with most prominent impairment in RV systolic function (S′ z score −2.7±0.8), RV early-diastolic filling (E′ z score −2.3±1.1), and LV early-diastolic filling (E′ z score −2.3±1.1). LV systolic function (S′ z score) and late-diastolic filling (A′ z score) improved to normal in 11 to 30 days, LV early-diastolic filling (E′ z score) in 4 to 6 months, and RV early-diastolic filling in 6 to 9 months (P<0.001 for all on longitudinal analysis). However, RV systolic function (RV S′ z score −1.2±1.1) remained impaired 1-year post-transplant. Analysis of serial cardiac catheterization studies showed that RV and LV filling pressures were elevated early post-HT and declined gradually during the first year post-transplant. Conclusions-Pediatric

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Section: Discussionmentioning

confidence: 99%