Comparative Analysis of Conventional and Speckle Tracking Echocardiographic Variables between Patients with
Aline Oliveira Martins Campo Dall'Orto1,2, Maria Estefania Otto2, Simone Ferreira Leite2
1Universidade de Brasilia, Brasília, DF - Brasil.
Insights
Heart transplant recipients without rejection show altered echocardiographic measures and heart mechanics compared to healthy individuals, even without signs of rejection. These findings impact clinical follow-up.
Area of Science:
- Cardiology
- Transplant Medicine
- Medical Imaging
Background:
- Echocardiography is crucial for heart transplant patient assessment.
- Normal echocardiographic values for heart transplant recipients are not well-defined.
Purpose of the Study:
- To compare echocardiographic and speckle tracking variables between heart transplant patients and healthy controls.
- To identify potential alterations in cardiac function post-transplant.
Main Methods:
- Prospective study comparing adult heart transplant patients (≥1 year post-transplant) with healthy volunteers.
- Utilized transthoracic echocardiogram (TTE) for conventional measures and speckle tracking for strain analysis.
- Statistical significance set at p < 0.05.
Main Results:
- Heart transplant patients (n=36) exhibited significantly lower global longitudinal strain (LV and RV) and altered myocardial work indices compared to controls (n=30).
- Transplant recipients showed larger left atrial size and increased left ventricular mass and relative wall thickness.
- Chagas disease was the primary indication for transplantation in the study group.
Conclusions:
- Stable heart transplant recipients without rejection demonstrate distinct echocardiographic profiles compared to healthy individuals.
- Conventional echocardiography and myocardial mechanics are affected in heart transplant patients, irrespective of rejection status.
- These alterations are clinically significant for patient management and long-term follow-up.
Background:
Echocardiography is essential for the assessment of patients with heart transplants. However, normal values in such individuals are not clearly defined.
Objectives:
To compare conventional echocardiographic and speckle tracking variables between patients with unrejected heart transplants and healthy individuals.
Methods:
:A prospective study was conducted with adult patients having undergone heart transplantation at least one year earlier and submitted to endomyocardial biopsy followed by transthoracic echocardiogram (TTE). Conventional TTE measures and mechanical heart strain assessments using speckle tracking were performed and the results were compared to those of a group of healthy volunteers. Statistical significance was set at 5% (p < 0.05).
Results:
Thirty-six transplant patients without rejection were analyzed and compared to 30 healthy individuals. Chagas disease was the main reason for transplantation. Lower left ventricular global longitudinal strain expressed in absolute values was found (11.99% in transplant patients vs. 20.60% in controls; p <0.0001), right ventricular free wall longitudinal strain (16.67% in transplant patients vs. 25.50% in controls; p <0.0001) and myocardial work indices (p < 0.0001) as well as a larger size of the left atrium (38.17 ml/m2 in transplant patients vs. 18.98 ml/m2 in controls; p <0.0001) and greater mass and relative wall thickness (p <0.0001).
Conclusion:
Stable patients having undergone heart transplants without rejection have differences concerning echocardiographic variables compared to healthy individuals. These findings indicate that conventional echocardiographic measures and heart mechanics are altered in transplant patients even in the absence of rejection. Such findings are relevant to the clinical context and follow-up of the patient.
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