Speckle tracking echocardiographyas a predictor of heart rejection in patients after orthotopic cardiac transplantation

Authors: T.V. Stavenchuk 1,2, 2, E.D. Kosmacheva 1,2, 2, I.A. Shelestova 1,2, 2, K.O. Barbukhatty 1,2, 2, V.A. Porkhanov 1,2, 2

Company: 1 S.V. Ochapovsky Region Clinical Hospital № 1; Ulitsa Pervogo Maya, 167, Krasnodar, 350063, Russian Federation;
2 Kubanskiy State Medical University of Ministry of Health of the Russian Federation; Ulitsa Sedina, 4, Krasnodar, 350063, Russian Federation.


DOI: https://doi.org/10.15275/kreatkard.2015.03.05

For citation:

Stavenchuk TV, Kosmacheva ED, Shelestova IA et al. Speckle tracking echocardiography as a predictor of heart rejection in patients after orthotopic cardiac transplantation. Creative Cardiology 2015; 3: 56-66 (in Russian)

Keywords: orthotopic cardiac transplantation deformation myocardium biopsy spacemen Global Peak Systolic Strain or strain rate of left ventricle

Full text:  

 

Abstract

Objective. To accomplish comparative analysis of standard transthoracic echocardiography parameters and speckle tracking imaging, and estimate its’ predictive value on transplant rejection in patients after orthotopic cardiac transplantation.

Material and methods. From March, 2013 to May, 2014 64 recipients of heart transplant were surveyed after 3±0.3 years after transplantation in S.V. Ochapovsky Region Clinical Hospital № 1 of Krasnodar. The endomyocardial biopsy (EMB), transthoracic echocardiography (TTE), speckle tracking echocardiography were carried out in all patients. According to the results of EMB, following groups were defined: group 1 (n=40) – recipients without signs of cellular or humoral transplant rejection (AMR0 and ACR0); group 2 (n=15) – recipients with AMR 1 and/or ACR1; group 3 (n=4) – patients with AMR2 and/or ACR2; group 4 (n=5) – with chronic transplant rejection. The control group (n=40): patients without valvular pathology, arterial hypertension, coronary heart disease.

Results. The sensitivity of left ventricular ejection fraction (LV EF) in diagnostics of early rejection of heart transplant in group 2 makes up 30%, specificity – 90%, in group 3 – 60% and 97%, respectively; in group 4 – 57% and 97%. Speckle tracking echocardiography method revealed decrease of a global peak systolic strain of left ventricle (GLPS LV) in group 2 patients. Both parameters of GLPS LV and twisting were lowered in group 3. Meanwhile GLPS LV, radial peak systolic strain of LV (RadS LV), circumferential peak systolic strain of LV (CirS LV) and twist were lowered in group 4. The Sensitivity of GLPS LV in diagnostics of early rejection of heart transplant in group 2 was 73%, specificity – 93%, in group 3 – 90 and 95%, respectively.

Conclusion. GLPS LV can be considered as a diagnostic criterion at an early stage of transplant rejection (ACR1 and/or AMR1).

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery