Journal ArticleDOI
Changes in Longitudinal Myocardial Deformation during Acute Cardiac Rejection: The Clinical Role of Two-Dimensional Speckle-Tracking Echocardiography
TLDR
GLS is significantly reduced during moderate (2R) ACR and improves significantly in the resolving period and the present results provide encouraging evidence to consider the routine use of GLS as a marker of graft function involvement during ACR.Abstract:
Background Diagnosing and monitoring acute cellular rejection (ACR) is a major objective in the surveillance of heart-transplanted patients. The aim of this study was to evaluate the value of global longitudinal strain (GLS), measured by two-dimensional speckle-tracking echocardiography, as a noninvasive tool for graft function monitoring in relation to ACR. Methods The study population consisted of all heart-transplanted patients who underwent biopsy and corresponding echocardiography at one institution from 2011 to 2013 ( n = 64). ACR was classified according to the International Society of Heart and Lung Transplantation (0R–3R). Changes in graft function were serially evaluated before, during, and in the resolving period after ACR. Results No sign of rejection was seen in 268 biopsies (52.7%), minimal rejection (1R) in 202 biopsies (39.7%), and moderate rejection (2R) in 39 biopsies (7.7%); no patients had severe (3R) rejection. A significant difference in GLS was observed comparing the groups with 0R (−15.5%; 95% confidence interval, −16.2% to −14.2%), 1R (−15.3%; 95% confidence interval, −16.0% to −14.6%), and 2R (−13.8%; 95% confidence interval, −14.6% to −12.9%) rejection ( P 2 years) after transplantation. In the serial assessment, GLS was decreasing significantly at the time of moderate 2R rejection and improved significantly in the resolving period. The traditional diastolic Doppler parameters, E-wave deceleration time and isovolumetric relaxation time, were unaffected by rejections, whereas the E/A and E/e′ ratios were significantly higher in the 2R group ( P = .004 and P = .01) compared with the 0R and 1R groups. Conclusions GLS is significantly reduced during moderate (2R) ACR and improves significantly in the resolving period. The present results provide encouraging evidence to consider the routine use of GLS as a marker of graft function involvement during ACR.read more
Citations
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Journal ArticleDOI
Tissue Tracking Technology for Assessing Cardiac Mechanics: Principles, Normal Values, and Clinical Applications
TL;DR: An overview of the normal values and reproducibility of the clinically applicable parameters, together with their clinical validation are provided, and the additive value to current imaging diagnostics are discussed.
Journal ArticleDOI
Post-transplant surveillance for acute rejection and allograft vasculopathy by echocardiography: Usefulness of myocardial velocity and deformation imaging.
Michael Dandel,Roland Hetzer +1 more
TL;DR: Echocardiography approaches can be a valuable supplement to EMB, enabling more efficient AR monitoring with fewer EMBs instead of unnecessary and distressing routine EMB screenings, and their use can also improve therapeutic decisions and monitoring of myocardial function during anti-rejection therapy.
Journal ArticleDOI
Left ventricular global longitudinal strain predicts major adverse cardiac events and all-cause mortality in heart transplant patients.
Tor Skibsted Clemmensen,Hans Eiskjær,Brian Bridal Løgstrup,Lars B. Ilkjaer,Steen Hvitfeldt Poulsen +4 more
TL;DR: Measurement of LVGLS strongly predicts MACE and mortality in long-term HTx patients and remained strong after adjustment for CAV, ACR score, hemoglobin, creatinine, and time since transplantation.
Journal ArticleDOI
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.
Journal ArticleDOI
Strain Imaging Echocardiography: What Imaging Cardiologists Should Know
TL;DR: The basic concepts of strain imaging are outlined to better understand the mechanism of myocardial function as well their applicability in the least common cardiac diagnosis among current clinical practice.
References
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Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart A Statement for Healthcare Professionals From the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association
Manuel D. Cerqueira,Neil J. Weissman,Vasken Dilsizian,Alice K. Jacobs,Sanjiv Kaul,Warren K. Laskey,Dudley J. Pennell,John A. Rumberger,Thomas J. Ryan,Mario S. Verani +9 more
TL;DR: Attempts to standardize options for all cardiac imaging modalities should be based on the sound principles that have evolved from cardiac anatomy and clinical needs, and selection of standardized methods must bebased on the following criteria.
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Recommendations for chamber quantification
Roberto M. Lang,Michelle Bierig,Richard B. Devereux,Frank A. Flachskampf,Elyse Foster,Patricia A. Pellikka,Michael H. Picard,Mary J. Roman,James D. Seward,Jack S. Shanewise,Scott Robert Solomon,Kirk T. Spencer,Martin St John Sutton,William W. Stewart +13 more
TL;DR: This document reviews the technical aspects on how to perform quantitative chamber measurements of morphology and function, which is a component of every complete echocardiographic examination.
Journal ArticleDOI
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.
Journal ArticleDOI
The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Journal ArticleDOI
International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy—2010
Mandeep R. Mehra,María G. Crespo-Leiro,Anne I. Dipchand,Stephan M. Ensminger,Nicola E. Hiemann,Jon A. Kobashigawa,Joren C. Madsen,Jayan Parameshwar,Randall C. Starling,Patricia A. Uber +9 more
TL;DR: This consensus document is based on best evidence and clinical consensus derived from critical analysis of available information pertaining to angiography, intravascular ultrasound imaging, microvascular function, cardiac allograft histology, circulating immune markers, non-invasive imaging tests, and gene-based and protein-based biomarkers.
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