Use of speckle-tracking echocardiography-derived strain and systolic strain rate measurements to predict rejection in transplant hearts with preserved ejection fraction
Use of speckle-tracking echocardiography-derived strain and systolic strain rate measurements to predict rejection in transplant hearts with preserved ejection fraction
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DOI：
10.1186/s12872-018-0980-4
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发表时间：
2018-12-22
影响因子：
2.1
通讯作者：
Villarraga, Hector R.
中科院分区：
文献类型：
--
作者：
Tseng, Andrew S.;Gorsi, Umama S.;Villarraga, Hector R.
背景
心脏移植受者同种异体移植物排斥反应的无创诊断具有挑战性。本研究评估了二维斑点追踪超声心动图（2D - STE）在预测左心室射血分数（LVEF）保留的心脏移植受者严重排斥反应中的应用价值。
方法
对1997年至2011年期间在明尼苏达州罗切斯特市梅奥诊所就诊的左心室射血分数保留（>55%）且经活检证实为严重排斥反应（排斥反应分级为2R）或无排斥反应的成年心脏移植患者进行评估。在活检后1个月内进行经胸超声心动图检查。回顾性分析左心室整体纵向和圆周应变及应变率（GLS、GLSR、GCS和GCSR）。
结果
纳入的65例患者中，25例有严重排斥反应，40例为无排斥反应的正常移植对照组。两组男性均多于女性（分别为64%和75%）。两组间基线临床变量相似。两组的左心室射血分数均正常（64.3%对64.5%；P = 0.87）。两组间所有非应变超声心动图变量相似。应变分析显示，早期舒张纵向应变率显著升高（P = 0.02），GCS降低（P……（此处原文似乎不完整）
BackgroundNoninvasive diagnosis of allograft rejection in heart transplant recipients is challenging. The utility of 2-dimensional speckle-tracking echocardiography (2D-STE) to predict severe rejection in heart transplant recipients with preserved left ventricular ejection fraction (LVEF) was evaluated.MethodsAdult heart transplant patients with preserved LVEF (>55%) and severe rejection by biopsy (Rejection Grade2R) or no rejection between 1997 and 2011 at the Mayo Clinic in Rochester, Minnesota were evaluated. Transthoracic echocardiography was performed within 1month of the biopsy. LV global longitudinal and circumferential strain and strain rates (GLS, GLSR, GCS, and GCSR) were analyzed retrospectively.ResultsOf 65 patients included, 25 had severe rejection and 40 were normal transplant controls without rejection. Both groups had more men than women (64 and 75%, respectively). Baseline clinical variables were similar between the groups. Both groups had normal LVEF (64.3% vs 64.5%; P=.87). All non-strain echocardiographic variables were similar between the 2 groups. Strain analysis showed significantly increased early diastolic longitudinal strain rate (P=.02) and decreased GCS (P