Evaluation of the predictive value of echocardiography parameters for heart transplant rejection: A tissue Doppler
Fereshteh Ghaderi1, Hoorak Poorzand2, Farveh Vakilian1
1Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Introduction:
The rate of heart transplantation is increasing worldwide. Due to the limitations of endomyocardial biopsy (EMB), various non-invasive methods have been suggested to assess rejection. Therefore, the aim of this study was to evaluate the predictive value of echocardiographic parameters to determine heart transplant rejection in a sample of Iranian patients.
Methods:
This was a cross-sectional study on heart transplant patients with available EMB results. All patients underwent echocardiography at the same day of EMB and prior to biopsy. The association between echocardiographic parameters and rejection was assessed using binary logistic regression.
Results:
A total of 67 patients (50, 74.6 % male and 17, 25.4 % female) with the mean age of 39.20 ± 11.39 years were enrolled in this study. Heart transplant rejection was observed in 22 (32.8 %) patients. There was only a significant difference in mitral inflow peak early diastolic velocity (E) and septal time to peak systolic velocity in ejection phase (septal Ts) between rejection and non-rejection groups. Logistic regression revealed a significant association between rejection and septal Ts (p = 0.048, OR = 0.931) and E velocity (p = 0.022, OR = 78.069). Based on ROC curve, the area under the curve for septal Ts and E were 81.9 % and 68.6 %. Moreover, the sensitivity and specificity for septal Ts and E in detection of rejection were 75 %, 69 % and 68 %, 61 %, respectively.
Conclusion:
Septal Ts could be used as a valuable echocardiographic parameter for predicting rejection in heart transplant recipients.
