Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients.

Autor: Wisotzkey BL; Division of Pediatric Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Jorgensen NW; Division of Biostatistics, Department of Pediatrics, University of Washington, Seattle, WA, USA., Albers EL; Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA., Kemna MS; Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA., Boucek RJ; Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA., Kronmal RA; Division of Biostatistics, Department of Pediatrics, University of Washington, Seattle, WA, USA., Law YM; Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA., Bhat AH; Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2017 Jun; Vol. 21 (4). Date of Electronic Publication: 2017 Mar 10.
DOI: 10.1111/petr.12909
Abstrakt: Evaluation of myocardial mechanics after heart transplant is important in monitoring allograft function and identifying rejection. Speckle tracking global longitudinal strain (GLS) may be more sensitive to early regional changes from rejection. This study aimed to determine feasibility of GLS in pediatric hearts during surveillance echocardiograms, compare their GLS to published norms (-18% to -22%), and assess association of GLS with other indices of graft function. Retrospective review of transplant echocardiograms from 2013 to 2014. Philips QLAB was used for post-acquisition GLS analysis. Multiple linear regression was used to assess the association of GLS with echocardiographic/catheterization indices, and B-type natriuretic peptide (BNP). Forty-seven patients (84 studies) were included. Calculation of GLS was feasible in 82 studies (97%) with inter- and intra-observer variability of 0.71 and 0.69. Patients (n=9) with rejection had GLS of -16.4% (SD=3.5%) compared to those without [-16.8% (SD=3.7%)]. GLS worsened linearly with increasing Ln(BNP) (P=<.001), left ventricular volume in diastole (P=<.001), septal a' wave (P=<.001), and pulmonary capillary wedge pressure (P=<.001). Speckle tracking-based GLS is feasible and reproducible in pediatric heart recipients and is reduced at baseline. The role of GLS and BNP in detecting early systolic dysfunction warrants further investigation.
(© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: