Delayed Rupture of Left Ventricular Apex After Heart Transplantation: Diagnosis by Two- and Three-Dimensional Transthoracic Echocardiography

2012 ◽  
Vol 30 (1) ◽  
pp. E26-E27 ◽  
Author(s):  
Ming-Chon Hsiung ◽  
Wei-Hsin Yin ◽  
Yang-Tsai Lee ◽  
Jen Wei
Keyword(s):  
Heart Transplantation ◽  
Transthoracic Echocardiography ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Left Ventricular Apex ◽  
Delayed Rupture

scholarly journals 1186 Three-dimensional analysis of right ventricle strain in transplanted hearts and rejection: an ongoing prospective study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
RCPLD Costa ◽  
A C T Rodrigues ◽  
C H Fischer ◽  
E B Lira-Filho ◽  
C G Monaco ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricle ◽  
Heart Transplantation ◽  
Three Dimensional ◽  
Posterior Wall ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Free Wall ◽  
Humoral Rejection ◽  
Cellular Rejection

Abstract Background The main obstacle for success after heart transplantation is graft rejection, since is mainly asymptomatic and diagnosed by endomyocardial biopsy (EMB). New echocardiographic technologies could bring benefits to that population if subtle changes in heart mechanics were related to an incipient state of rejection. Purpose To quantify echocardiographic parameters of right ventricle strain and volumes by a semi-automated offline software and to identify the presence of any relation between those findings and the histopathologic diagnose of rejection. Methods a prospective cohort of 35 postoperative heart transplant patients who were submitted to echocardiographic evaluation up to six hours after EMB, including two-dimensional chamber quantification of left ventricular (LV) volumes and ejection fraction; conventional and tissue Doppler measurements were used for flow and functional analysis. Offline assessment of the right ventricle (RV) was made by TOMTEC software, with the acquisition of RV volumes (EDV, ESV, SV) and ejection fraction, TAPSE, FAC and three-dimensional(3D) RV free wall and septal strain using speckle tracking. EMB results were classified as positive for cellular rejection if graded as 2R (two or more interstitial infiltrate spots and myocyte damage) and positive for humoral rejection if they show any response by immunofluorescence assay. Results We studied 35 patients, aged 50 ±11, 21 male (67%), totaling 58 examinations, and then we made two analysis of EMB: one in two groups regarding cellular rejection (53 negative and 5 positive) and other regarding humoral rejection (50 negative and 8 positive). RVEDV was higher in the cellular rejection group (112,5 ± 29,6 ml) compared to those with negative biopsy (86,8 ± 24,7 mL; p = 0,01). RV stroke volume showed a similar behavior (53,5 ± 22,3 mL vs. 34,5 ± 11,3 mL; p < 0,01). Regarding humoral rejection by immunofluorescence, patients who tested positive showed lower RVEDV (79,5 ± 10,5 mL vs. 90,57 ± 27,31 mL; p = 0,02) and RVESV (45,53 ± 6,33 mL vs. 53,87 ± 19,87 mL; p = 0,01). RV free wall strain was lower in the group with positive immunofluorescence (-18,35 ± 2,79% vs. -15,34 ± 5,35%; p = 0,01). Regarding 2D measurements , interventricular septal (11,5 ± 1,06 mm vs. 10,56 ± 1,38 mm; p = 0,02) and left ventricular posterior wall (10,75 ± 1,03 mm vs. 10,04 ± 1,1 mm; p = 0,05) were also thicker in the group with positive immunofluorescence for rejection. Conclusion Both cellular and humoral rejection after heart transplantation are associated to increased 3D RV volumes whereas a decrease in RV free wall strain is only observed in humoral rejection; in patients with positive immunofluorescence results a significant increase is seen for septal and posterior wall thickness.

scholarly journals EACVI survey on standardization of cardiac chambers quantification by transthoracic echocardiography

2019 ◽  
Vol 21 (2) ◽  
pp. 119-123 ◽  
Author(s):  
Nina Ajmone Marsan ◽  
Blazej Michalski ◽  
Matteo Cameli ◽  
Tomaz Podlesnikar ◽  
Robert Manka ◽  
...  
Keyword(s):  
Transthoracic Echocardiography ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Good Adherence ◽  
Cardiac Device ◽  
Myocardial Deformation Imaging ◽  
Three Dimensional Echocardiography ◽  
The Right ◽  
And Function

Abstract Aims To evaluate standard reporting of cardiac chambers size and function by transthoracic echocardiography (TTE), the EACVI Scientific Initiatives Committee performed a survey across European centres. In particular, the routine use of three-dimensional echocardiography (3DE) and speckle tracking-derived myocardial deformation imaging (STE) was explored. Methods and results A total of 96 European Echocardiography Laboratories from 22 different countries responded to the survey, which consisted of 20 questions. For most of the standard parameters of cardiac chamber size and function, answers from the centres were homogeneous and demonstrated good adherence to current recommendations. In particular, all centres assessed left ventricular (LV) and left atrial (LA) size combining diameter measurements with volumes obtained using the bi-plane Simpson’s method. More variability was observed in the measurements of the right heart chambers and thoracic aorta. Interestingly, >90% of centres had access to 3DE and STE; however, the large majority of centres reserved the use of these techniques for selected cases, particularly for the measure of 3D LV volumes and ejection fraction and global longitudinal strain in patients being considered for cardiac device implantation, surgical intervention (valvular heart disease) or screened for cardiotoxicity. Only 10% of centres used 3DE for right ventricular and LA volumes. Also, <30% of the centres used LA strain imaging. Conclusion In Europe, a good adherence to current recommendations was observed for most of the standard parameters of cardiac chambers quantification by TTE. Advanced echocardiography modalities, such as 3DE and STE, are widely available but used only in selected cases.

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