Right Atrial Contraction Strain Is Associated With Clinically Significant Cellular Rejection in Patients After Heart...

Area of Science:

• Cardiology
• Transplant Medicine
• Medical Imaging

Background:

• Strain echocardiography (SE) is used for heart transplant (HTx) surveillance.
• Data on atrial strain's role in detecting acute cellular rejection (ACR) post-HTx is limited.

Purpose of the Study:

• To compare the significance of ventricular and atrial strain in identifying ACR after HTx.
• To assess the utility of SE parameters in relation to ACR.

Main Methods:

• Retrospective analysis of 52 HTx patients undergoing endomyocardial biopsy (EMB) within one year post-transplant.
• Assessed the relationship between SE parameters (ventricular and atrial strain) and ACR severity determined by EMB.
• Validated findings in a separate group of 23 HTx patients.

Main Results:

• ACR (≥ moderate) was associated with reduced right ventricular free wall strain and right atrial contraction strain (RASct).
• A RASct cut-off of -9.3% demonstrated 100% sensitivity and 79% specificity for detecting ≥ moderate ACR.
• No significant associations were found for left-sided ventricular or atrial strain.

Conclusions:

• Reduced right ventricular strain and RASct are associated with ACR post-HTx.
• Right atrial strain analysis, particularly RASct, shows promise for excluding subclinical ACR in heart transplant recipients.