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Serial Changes in Right Ventricular Systolic Function Among Rejection-Free Children and Young Adults After Heart

Jamie K Harrington1, Marc E Richmond1, Kristal L Woldu1

  • 1Department of Pediatrics, Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, New York.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|June 17, 2019
PubMed

Insights

Right ventricular (RV) systolic function improves after pediatric heart transplantation (HT) but remains abnormal one year post-procedure. Infants show better RV function recovery following HT, highlighting the importance of longitudinal contractility assessment.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Transplantation Medicine

Background:

  • Right ventricular (RV) systolic function post-pediatric heart transplantation (HT) is not well-documented.
  • Understanding RV function evolution is crucial for managing young heart transplant recipients.

Purpose of the Study:

  • To describe the changes in RV systolic function during the first year after pediatric HT in rejection-free patients.
  • To compare RV function recovery between infants and older children post-HT.

Main Methods:

  • Echocardiographic assessment of RV function using TAPSE, S', FAC, MPI, GLS, and FWS in 96 pediatric HT patients.
  • Analysis of RV function parameters at baseline and up to one year post-transplant.
  • Stratification of patients into infants (≤1 year) and non-infants (>1 year).

Main Results:

  • RV function parameters were impaired immediately after HT but showed significant improvement within the first year.
  • Fractional area change (FAC) and myocardial performance index (MPI) nearly normalized by one year.
  • Tricuspid annular plane systolic excursion (TAPSE), S', global longitudinal strain (GLS), and free wall strain (FWS) remained abnormal at one year post-HT.
  • Infants demonstrated superior recovery of RV systolic function compared to older children.

Conclusions:

  • RV systolic function improves after pediatric HT, yet longitudinal contractility measures remain suboptimal at one year.
  • These findings enhance the quantitative assessment of RV function in pediatric HT survivors.
  • Early recovery patterns suggest potential differences in RV adaptation based on age at transplantation.
Abstract

Keywords:
EchocardiographyPediatric heart transplantationRight ventricleSystolic function

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