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Early detection of left ventricular dysfunction related to transplant coronary artery disease

Michael Dandel1, Ernst Wellnhofer, Manfred Hummel

  • 1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. dandel@dhzb.de

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|December 16, 2003
PubMed

Insights

Pulsed-wave tissue Doppler imaging (PW-TDI) effectively detects early signs of transplant coronary artery disease (TxCAD) by assessing left ventricular (LV) function. PW-TDI systolic parameters are highly predictive of TxCAD, aiding in early diagnosis and prognosis.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Diagnostic Imaging

Background:

  • Transplant coronary artery disease (TxCAD) significantly impacts long-term cardiac allograft survival.
  • Early diagnosis and severity assessment of myocardial damage in TxCAD are crucial.

Purpose of the Study:

  • To evaluate left ventricular (LV) function in relation to coronary lesion severity in heart transplant recipients.
  • To improve early diagnosis of TxCAD and assess myocardial damage severity.

Main Methods:

  • Echocardiography, including pulsed-wave tissue Doppler imaging (PW-TDI) wall motion analysis, was performed in 304 heart recipients.
  • LV systolic and diastolic parameters were correlated with angiographic and intravascular ultrasound (IVUS) findings.

Main Results:

  • Significant differences in LV end-diastolic pressure and most PW-TDI parameters were observed between patients with and without TxCAD (p < 0.001).
  • Moderate, angiographically non-visible TxCAD showed significant differences in systolic PW-TDI parameters.
  • Systolic PW-TDI parameters, particularly systolic wall motion peak velocity (Sm), demonstrated high predictive value for TxCAD detection.

Conclusions:

  • PW-TDI systolic parameters offer the greatest diagnostic value for evaluating allograft LV function in TxCAD.
  • Wall motion assessment via PW-TDI enables early detection of myocardial dysfunction and provides insights into LV dysfunction.
  • This technique aids in timing cardiac catheterizations and prognostic evaluation for TxCAD patients.
Abstract

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