Altered Biatrial Phasic Function after Heart Transplantation in Children.

Area of Science:

• Cardiology
• Pediatric Cardiology
• Transplantation Medicine

Background:

• Pediatric heart transplantation (HT) is a life-saving procedure.
• Assessing the long-term function of cardiac structures post-transplantation is crucial for patient outcomes.
• Atrial function plays a vital role in overall cardiac hemodynamics.

Purpose of the Study:

• To investigate alterations in left and right atrial (LA and RA) phasic function in pediatric heart transplant (HT) patients.
• To explore the relationship between atrial function and HT-related clinical variables.

Main Methods:

• Two-dimensional echocardiographic speckle-tracking was used to measure atrial deformation indices (strain and strain rates).
• Phasic atrial function components (reservoir, conduit, booster) were calculated for both LA and RA.
• Comparisons were made between 36 HT recipients and 50 healthy children, with correlations to clinical data.

Main Results:

• Pediatric HT recipients exhibited reduced reservoir, conduit, and booster function in both LA and RA compared to controls.
• No significant relationship was found between atrial deformation and age at HT, bypass time, or ischemia time.
• LA conduit function showed a weak correlation with donor age, and RA function correlated with the duration of HT.

Conclusions:

• Atrial strain analysis is feasible in pediatric HT recipients.
• Disruption of reservoir, conduit, and booster function is evident in both atria post-HT.
• Ventricular diastolic dysfunction is speculated as a potential cause for the observed atrial dysfunction.