학술논문
Usefulness of speckle tracking echocardiography and biomarkers for detecting acute cellular rejection after heart transplantation
Document Type
article
Author
Cecilia Beatriz Bittencourt Viana Cruz; Ludhmila A. Hajjar; Fernando Bacal; Marco S. Lofrano-Alves; Márcio S. M. Lima; Maria C. Abduch; Marcelo L. C. Viera; Hsu P. Chiang; Juliana B. C. Salviano; Isabela Bispo Santos da Silva Costa; Julia Tizue Fukushima; Joao C. N. Sbano; Wilson Mathias; Jeane M. Tsutsui
Source
Cardiovascular Ultrasound, Vol 19, Iss 1, Pp 1-11 (2021)
Subject
Language
English
ISSN
1476-7120
Abstract
Abstract Background Acute cellular rejection (ACR) is a major complication after heart transplantation. Endomyocardial biopsy (EMB) remains the gold standard for its diagnosis, but it has concerning complications. We evaluated the usefulness of speckle tracking echocardiography (STE) and biomarkers for detecting ACR after heart transplantation. Methods We prospectively studied 60 transplant patients with normal left and right ventricular systolic function who underwent EMB for surveillance 6 months after transplantation. Sixty age- and sex-matched healthy individuals constituted the control group. Conventional echocardiographic parameters, left ventricular global longitudinal, radial and circumferential strain (LV-GLS, LV-GRS and LV-GCS, respectively), left ventricular systolic twist (LV-twist) and right ventricular free wall longitudinal strain (RV-FWLS) were analyzed just before the procedure. We also measured biomarkers at the same moment. Results Among the 60 studied patients, 17 (28%) had severe ACR (grade ≥ 2R), and 43 (72%) had no significant ACR (grade 0 – 1R). The absolute values of LV-GLS, LV-twist and RV-FWLS were lower in transplant patients with ACR degree ≥ 2 R than in those without ACR (12.5% ± 2.9% vs 14.8% ± 2.3%, p=0.002; 13.9° ± 4.8° vs 17.1° ± 3.2°, p=0.048; 16.6% ± 2.9% vs 21.4%± 3.2%, p