Changes in circumferential strain can differentiate pediatric heart transplant recipients with and without graft rejection.
Changes in circumferential strain can differentiate pediatric heart transplant recipients with and without graft rejection.
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DOI：
10.1111/petr.14195
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发表时间：
2022-03
影响因子：
1.3
通讯作者：
Chowdhury, Shahryar M.
中科院分区：
文献类型：
--
作者：
Boucek, Katerina;Burnette, Ali;Henderson, Heather;Savage, Andrew;Chowdhury, Shahryar M.
关键词：
常规的监视方案严重依赖内膜活检（EMB）来检测小儿心脏移植受者的排斥反应，以评估拒绝的更敏感的超声心动图。与那些没有拒绝相比。
在2013年至2020年之间进行了单一的回顾性审查。在拒绝组中，评估了2个EMB的拒绝史测量了LV功能和斑点跟踪超声心动图衍生的纵向（LS）和圆周菌株（CS）的度量。
17例在非排斥组中，在拒绝组中有17例（总排斥异常）在移植时年龄较大。在第二次超声心动图[-18.5（IQR -21.5，-14.6）至-15.7（IQR -19.8，-13.2）]的排斥组中可见，而非排斥组的CS改进[-20.8（IQR -23.9，IQR -23.9，， -17.8）至-23.9（IQR -24.9，-20.1）。更改（p = .24）。
非排斥组中的患者在超声心动图之间表现出CS的改善，而排斥组的患者随后显示出LV CS的恶化。
Routine surveillance protocols rely heavily on endomyocardial biopsy (EMB) for detection of rejection in pediatric heart transplant recipients. More sensitive echocardiographic tools to assess rejection may help limit the number of EMBs. This study compared changes in left ventricular (LV) strain in patients who had rejection versus those who did not. A single center retrospective review was conducted between 2013 and 2020. Patients were categorized based on rejection history. Echocardiograms were evaluated at the time of 2 consecutive EMBs; in the rejection group, the second echocardiogram was collected at the time of a rejection episode. Conventional measures of LV function and speckle-tracking echocardiography-derived longitudinal (LS) and circumferential strain (CS) were measured. 17 patients were in the non-rejection group and 17 were in the rejection group (30 total rejection episodes). The rejection group was older at the time of transplant (12.5 vs. 1.3 years, p = .01). A decline in CS was seen in the rejection group at the second echocardiogram [−18.5 (IQR −21.5, −14.6) to −15.7 (IQR −19.8, −13.2)] while CS improved in the non-rejection group [−20.8 (IQR −23.9, −17.8) to −23.9 (IQR −24.9, −20.1)]. This difference in change reached significance (p = .02). A similar pattern was seen in LS that neared significance (p = .06). There was no significant difference in ejection fraction change (p = .24). Patients in the non-rejection group displayed improvement in CS between echocardiograms while patients in the rejection group showed subsequent decline. Worsening of LV CS may help identify acute rejection in the early post-transplant period.
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DOI：
10.1111/echo.14481
发表时间：
2019-10-01
影响因子：
1.5
作者：
Engelhardt, Kevin;Das, Bibhuti;Lemler, Matthew
通讯作者：
Lemler, Matthew
影响因子：
2.1
作者：
Tseng, Andrew S.;Gorsi, Umama S.;Villarraga, Hector R.
通讯作者：
Villarraga, Hector R.
影响因子：
7.5
作者：
Lunze, Fatima I.;Colan, Steven D.;Singh, Tajinder P.
通讯作者：
Singh, Tajinder P.
影响因子：
3.1
作者：
Dipchand, Anne I.
通讯作者：
Dipchand, Anne I.
影响因子：
8.9
作者：
Stewart, S;Winters, GL;Billingham, ME
通讯作者：
Billingham, ME