P660Two-dimensional speckle tracking echocardiography in heart transplant patients: three-year follow-up of deformation parameters and ejection fraction derived from transthoracic echocardiography


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Abstract

Purpose: Non-invasive diagnosis of allograft dysfunction is a major objective in the management of heart transplant recipients. Speckle tracking echocardiography (STE) permits reliable and comprehensive assessment of myocardial function. It is known that deformation indices are reduced in heart transplants when compared to control subjects. However, it is unclear if these patients exhibit altered strain values in serial follow up analysis.Method: Three years follow-up transthoracic echocardiography was performed in 20 “healthy” heart transplant patients (13.2 years post transplantation; average age: 68.0±9.2 years) with normal ejection fraction and angiographically ruled out allograft vasculopathy. Grey-scale apical 2-, 3- and 4-chamber views were recorded and stored for automated offline speckle tracking (EchoPAC 7.0, GE) of the 16 segments of the left ventricle.Results: Strain analysis was performed in 320 segments 34.3±3.7 months after initial assessment. Automated tracking of myocardial deformation for determination of longitudinal systolic strain was not possible in 24 (7.5%) segments at baseline and in 32 (10.0%) segments at follow-up (p=ns). Left ventricular ejection fraction was 61.9±8.1% at the initial examination vs. 62.8±5.8% three years afterwards (p=ns). Global longitudinal peak systolic strain was -14.0±4.0% vs. -14.4±2.8%, respectively (p=ns).Conclusion: To our knowledge, this is the first study describing follow-up deformation parameters in heart transplant patients undergoing STE. “Healthy” heart transplant patients with normal coronary arteries and normal ejection fractions showed no changes in longitudinal strain values 3 years after the initial assessment. Apparently, deformation values remain constant over the years as long as the left ventricular ejection fraction is preserved.

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