Cardiac allograft function during the first year after transplantation in rejection-free children and young adults.
Fatima I Lunze,Steven D. Colan,Kimberlee Gauvreau,Ming-Hui Chen,Antonio R. Perez-Atayde,Elizabeth D. Blume,Tajinder P. Singh +6 more
TLDR
Pediatric HT recipients have biventricular dysfunction using pulsed-wave tissue Doppler imaging early after HT with most significant impairment in RV systolic function and RV and LV early-diastolic filling.Abstract:
Background— Allograft dysfunction is a common finding early after heart transplant (HT). We sought to assess the recovery of left (LV) and right ventricular (RV) function during the first year after HT in children and young adults using pulsed-wave tissue Doppler imaging.
Methods and Results— We analyzed serially performed echocardiography in 44 pediatric HT recipients (median age: 7.3 years at HT) who remained rejection-free during the first year post-transplant. Age-based normative values for systolic ( S ′), early-diastolic ( E ′), and late-diastolic ( A ′) velocities obtained using pulsed-wave tissue Doppler imaging in 380 healthy children were used to transform patient data into z scores. Pulsed-wave tissue Doppler imaging studies ≤10 days post-HT demonstrated biventricular systolic and diastolic dysfunction with most prominent impairment in RV systolic function ( S ′ z score −2.7±0.8), RV early-diastolic filling ( E ′ z score −2.3±1.1), and LV early-diastolic filling ( E ′ z score −2.3±1.1). LV systolic function ( S ′ z score) and late-diastolic filling ( A ′ z score) improved to normal in 11 to 30 days, LV early-diastolic filling ( E ′ z score) in 4 to 6 months, and RV early-diastolic filling in 6 to 9 months ( P <0.001 for all on longitudinal analysis). However, RV systolic function (RV S ′ z score −1.2±1.1) remained impaired 1-year post-transplant. Analysis of serial cardiac catheterization studies showed that RV and LV filling pressures were elevated early post-HT and declined gradually during the first year post-transplant.
Conclusions— Pediatric HT recipients have biventricular dysfunction using pulsed-wave tissue Doppler imaging early after HT with most significant impairment in RV systolic function and RV and LV early-diastolic filling. Although other aspects of LV and RV function normalize in 6 to 9 months, RV systolic function remains abnormal 1 year-post-transplant.read more
Citations
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Prognostic value of coronary computed tomographic angiography in comparison with calcium scoring and clinical risk scores.
Martin Hadamitzky,Roland Distler,Tanja Meyer,Franziska Hein,Adnan Kastrati,Stefan Martinoff,Albert Schömig,Jörg Hausleiter +7 more
TL;DR: In patients with suspected CAD, CCTA not only detects coronary stenosis but also improves prediction of cardiac events over and above conventional risk scores and calcium scoring, which may result in a reclassification of cardiovascular risk in a substantial proportion of patients.
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Early predictors of survival to and after heart transplantation in children with dilated cardiomyopathy.
Biagio A. Pietra,Paul F. Kantor,Heather L. Bartlett,Clifford Chin,Charles E. Canter,Ranae L. Larsen,R. Erik Edens,Steven D. Colan,Jeffrey A. Towbin,Steven E. Lipshultz,James K. Kirklin,David C. Naftel,Daphne T. Hsu +12 more
TL;DR: Although 97% of children with clinically or biopsy-diagnosed myocarditis at presentation survived to transplantation, they had significantly higher posttransplantation mortality compared with children without myocardopathy, raising the possibility that preexisting viral infection or inflammation adversely affects graft survival.
Assessment of Mitral Annulus Velocity by Doppler Tissue lmaging in the Evaluation of Left Ventricular Diastolic Function
TL;DR: Mitral annulus velocity determined by DTI is a relatively preload-independent variable in evaluating diastolic function.
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Childhood Air Pollutant Exposure and Carotid Artery Intima-Media Thickness in Young Adults
Carrie V. Breton,Xinhui Wang,Wendy J. Mack,Kiros Berhane,Milena Lopez,Talat Islam,Mei Feng,Fred Lurmann,Rob McConnell,Howard N. Hodis,Nino Künzli,Edward L. Avol +11 more
TL;DR: The Testing Responses on Youth study consists of 861 college students recruited from the University of Southern California in 2007 to 2009 and participants attended 1 study visit during which blood pressure, heart rate, and carotid artery intima-media thickness (CIMT) were assessed as discussed by the authors.
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Serial changes in longitudinal graft function and implications of acute cellular graft rejections during the first year after heart transplantation
TL;DR: It was found that LV-GLS and tricuspid annular plane systolic excursion (TAPSE) were significantly related to ACR burden in a linear regression model.
References
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Roberto M. Lang,Michelle Bierig,Richard B. Devereux,Frank A. Flachskampf,Elyse Foster,Patricia A. Pellikka,Michael H. Picard,Mary J. Roman,James B. Seward,Jack S. Shanewise,Scott D. Solomon,Kirk T. Spencer,Martin St. John Sutton,William J. Stewart +13 more
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Revision of the 1990 Working Formulation for the Standardization of Nomenclature in the Diagnosis of Heart Rejection
Susan Stewart,Michael C. Fishbein,G.I. Snell,Gerald J. Berry,Annette Boehler,Margaret Burke,A. Glanville,F. Kate Gould,Cynthia Magro,Charles C. Marboe,K. McNeil,Elaine F. Reed,Nancy L. Reinsmoen,John P. Scott,Sean M. Studer,Henry D. Tazelaar,John Wallwork,G.P. Westall,Martin Zamora,Adriana Zeevi,Samuel A. Yousem +20 more
TL;DR: This article summarizes the revised consensus classification of lung allograft rejection and recommends the evaluation of antibody-mediated rejection, recognizing that this is a controversial entity in the lung, less well developed and understood than in other solid-organ grafts, and with no consensus reached on diagnostic features.
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Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function.
Dae-Won Sohn,In-Ho Chai,Dong-Jun Lee,Hee Chan Kim,Hyo-Soo Kim,Byung Hee Oh,Myoung-Mook Lee,Young-Bae Park,Yun-Shik Choi,Jung-Don Seo,Young-Woo Lee +10 more
TL;DR: In this article, the authors assessed the clinical utility of mitral annulus velocity in the evaluation of left ventricular diastolic function and found that mitral velocity determined by DTI is a relatively preload-independent variable in evaluating diASTolic function.
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Doppler Estimation of Left Ventricular Filling Pressure in Sinus Tachycardia A New Application of Tissue Doppler Imaging
Sherif F. Nagueh,Issam Mikati,Helen A. Kopelen,Katherine J. Middleton,Miguel A. Quinones,William A. Zoghbi +5 more
TL;DR: The ratio of transmitral E velocity to Ea can be used to estimate pulmonary capillary wedge pressure (PCWP) with reasonable accuracy in sinus tachycardia, even with complete merging of E and A velocities.
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Theoretical and empirical derivation of cardiovascular allometric relationships in children
TL;DR: Body surface area was found to be a more important determinant of the size of each of the cardiovascular structures than age, height, or weight alone and fit a complex model predicted by the nonlinear decrease of heart rate with growth.
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