Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article 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 < 0.001; respectively), while no differences were observed between the LV-GRS or LV-GCS. All of these parameters were lower in the transplant group without ACR than in the nontransplant control group, except for the LV-twist. Cardiac troponin I levels were significantly higher in patients with significant ACR than in patients without significant ACR [0.19 ng/mL (0.09-1.31) vs 0.05 ng/mL (0.01-0.18), p=0.007]. The combination of troponin with LV-GLS, RV-FWLS and LV-Twist had an area under curve for the detection of ACR of 0.80 (0.68-0.92), 0.89 (0.81-0.93) and 0.79 (0.66-0.92), respectively.
Conclusion: Heart transplant patients have altered left ventricular dynamics compared with control individuals. The combination of troponin with strain parameters had higher accuracy for the detection of ACR than the isolated variables and this association might select patients with a higher risk for ACR who will benefit from an EMB procedure in the first year after heart transplantation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797113 | PMC |
| http://dx.doi.org/10.1186/s12947-020-00235-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical experience of a systemic algorithm for diagnosis of cardiac amyloidosis.
Dan Med J
August 2025
Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital.
Introduction: Cardiac amyloidosis is an underdiagnosed disease, and its prevalence is probably higher than previously estimated. We aimed to investigate the effect of introducing a systemic diagnostic algorithm for cardiac amyloidosis in clinical practice.
Methods: A systematic diagnostic algorithm was developed and clinically applied in two hospitals in Eastern Denmark.
Totally endoscopic mitral valve replacement for mitral regurgitation post-transcatheter aortic valve implantation: a case report.
Eur Heart J Case Rep
September 2025
Department of Cardiology, Toyohashi Heart Center, 21-1 Gobutori, Oyamacho, Toyohashi 441-8530, Japan.
Background: Mitral regurgitation (MR) may rarely worsen after transcatheter aortic valve implantation (TAVI) due to mechanical interference from the transcatheter heart valve (THV). Standard surgical approaches in these cases are often challenging due to anatomical constraints. Thus, there is a need for the development of effective alternatives to address this issue.
View Article and Find Full Text PDFBreast cancer surgery under mechanical circulatory support in a patient with cancer therapy-related cardiac dysfunction: a case report.
Eur Heart J Case Rep
September 2025
Cardiovascular Department, Tokushima University Hospital, 7708503 Kuramoto-cho, Tokushima 2-50-1, Japan.
Background: The incidence of cancer therapy-related cardiac dysfunction is increasing with the growing number of breast cancer patients. In particular, patients with active cancer combined with severe irreversible cardiac dysfunction present significant challenges in treatment decision-making.
Case Summary: A 40-year-old woman with Stage II HER-2-positive breast cancer received anthracycline followed by HER2-targeted agents.
Hypertension burden in CKD: is nocturnal hypertension the primary culprit?
Clin Kidney J
September 2025
Hypertension is a pervasive and progressive complication in chronic kidney disease (CKD) patients, affecting up to 90% of those in advanced stages or on dialysis. A particularly insidious aspect of this condition is nocturnal hypertension, characterized by high blood pressure (BP) during sleep and a blunted or absent nighttime BP dipping-phenomena associated with accelerated CKD progression and increased cardiovascular risk. Despite its strong prognostic significance, nocturnal hypertension remains underdiagnosed due to limited use of ambulatory BP monitoring.
View Article and Find Full Text PDFRisk Factors of Subclinical Left Ventricular Systolic Dysfunction in Older Adults with Type 2 Diabetes and Preserved LVEF.
Clin Interv Aging
September 2025
Department of Nephrology, Huadong Hospital, Fudan University, Shanghai, People's Republic of China.
Objective: This study evaluates cardiac function in older adults with T2DM and preserved LVEF using two-dimensional speckle-tracking echocardiography to explore the risk factors associated with subclinical left ventricular systolic dysfunction (GLS <18%) in this population.
Methods: All patients (n = 87, aged 60 years and above) and controls (n = 20) underwent clinical assessment and echocardiography, including GLS assessment.
Results: Univariate analysis identified gender (OR 3.