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Impaired Right Ventricular Function in Heart Transplant Rejection.

心脏移植排斥反应中右心室功能受损。

  • 影响因子:1.00
  • DOI:10.36660/abc.20190054
  • 作者列表:"Carrion LJBM","Sperotto A","Nazario R","Goldraich LA","Clausell N","Rohde LE","Santos ABS
  • 发表时间:2020-04-01
Abstract

BACKGROUND:The practice of screening for complications has provided high survival rates among heart transplantation (HTx) recipients. OBJECTIVES:Our aim was to assess whether changes in left ventricular (LV) and right ventricular (RV) global longitudinal strain (GLS) are associated with cellular rejection. METHODS:Patients who underwent HTx in a single center (2015 - 2016; n = 19) were included in this retrospective analysis. A total of 170 biopsies and corresponding echocardiograms were evaluated. Comparisons were made among biopsy/echocardiogram pairs with no or mild (0R/1R) evidence of cellular rejection (n = 130 and n = 25, respectively) and those with moderate (2R) rejection episodes (n=15). P-values < 0.05 were considered statistically significant Results: Most patients were women (58%) with 48 ± 12.4 years of age. Compared with echocardiograms from patients with 0R/1R rejection, those of patients with 2R biopsies showed greater LV posterior wall thickness, E/e' ratio, and E/A ratio compared to the other group. LV systolic function did not differ between groups. On the other hand, RV systolic function was more reduced in the 2R group than in the other group, when evaluated by TAPSE, S wave, and RV fractional area change (all p < 0.05). Furthermore, RV GLS (-23.0 ± 4.4% in the 0R/1R group vs. -20.6 ± 4.9% in the 2R group, p = 0.038) was more reduced in the 2R group than in the 0R/1R group. CONCLUSION:In HTx recipients, moderate acute cellular rejection is associated with RV systolic dysfunction as evaluated by RV strain, as well as by conventional echocardiographic parameters. Several echocardiographic parameters may be used to screen for cellular rejection.

摘要

背景: 在心脏移植 (HTx) 受者中,筛查并发症的实践提供了高存活率。 目的: 我们的目的是评估左心室 (LV) 和右心室 (RV) 整体纵向应变 (GLS) 的变化是否与细胞排斥相关。 方法: 在单中心 (2015 - 2016; n = 19) 接受HTx的患者被纳入本回顾性分析。共评估了170例活检和相应的超声心动图。在无或轻度 (0R/1R) 细胞排斥 (分别为n = 130和n = 25) 和中度 (2R) 排斥发作 (n = 15) 的活检/超声心动图对之间进行比较。P值 <0.05被认为是统计学上显著的结果: 大多数患者是48 ± 58% 岁的女性 (12.4)。与0R/1R排斥反应患者的超声心动图相比,具有2R活检的患者的超声心动图显示与另一组相比更大的LV后壁厚度、E/e' 比率和E/A比率。两组间左室收缩功能无差异。另一方面,当通过TAPSE、S波和RV分数面积变化评估时,2R组的RV收缩功能比另一组降低更多 (均p <0.05)。此外,RV GLS (0R/1R组为-23.0 ± 4.4%,2R组为-20.6 ± 4.9%,p = 0.038) 在2R组比0R/1R组降低更多。 结论: 在HTx受体中,中度急性细胞排斥与RV收缩功能障碍相关,通过RV应变以及常规超声心动图参数评估。若干超声心动图参数可用于筛选细胞排斥。

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影响因子:1.67
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DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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