Assessment of cardiac allograft systolic function by global longitudinal strain: From donor to recipient

Adam D. DeVore, Fawaz Alenezi, Arun Krishnamoorthy, Mads Ersboll, Marc D. Samsky, Phillip Schulte, Chetan B. Patel, Joseph G. Rogers, Carmelo A. Milano, Eric J. Velazquez, Michel G. Khouri

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Cardiac allografts are routinely evaluated by left ventricular ejection fraction (LVEF) before and after transplantation. However, myocardial deformation analyses with LV global longitudinal strain (GLS) are more sensitive for detecting impaired LV myocardial systolic performance compared with LVEF. Methods: We analyzed echocardiograms in 34 heart donor-recipient pairs transplanted at Duke University from 2000 to 2013. Assessments of allograft LV systolic function by LVEF and/or LV GLS were performed on echocardiograms obtained pre-explanation in donors and serially in corresponding recipients. Results: Donors had a median LVEF of 55% (25th, 75th percentile, 54% to 60%). Median donor LV GLS was −14.6% (−13.7 to −17.3%); LV GLS was abnormal (ie, >−16%) in 68% of donors. Post-transplantation, LV GLS was further impaired at 6 weeks (median -11.8%; −11.0 to −13.4%) and 3 months (median −11.4%; −10.3 to −13.9%) before recovering to pretransplant levels in follow-up. Median LVEF remained ≥50% throughout follow-up. We found no association between donor LV GLS and post-transplant outcomes, including all-cause hospitalization and mortality. Conclusions: GLS demonstrates allograft LV systolic dysfunction in donors and recipients not detected by LVEF. The clinical implications of subclinical allograft dysfunction detected by LV GLS require further study.

Original languageEnglish (US)
Article numbere12961
JournalClinical Transplantation
Volume31
Issue number5
DOIs
StatePublished - May 1 2017

Keywords

  • donor selection
  • echocardiography
  • heart transplant
  • left ventricular function
  • strain

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'Assessment of cardiac allograft systolic function by global longitudinal strain: From donor to recipient'. Together they form a unique fingerprint.

  • Cite this

    DeVore, A. D., Alenezi, F., Krishnamoorthy, A., Ersboll, M., Samsky, M. D., Schulte, P., Patel, C. B., Rogers, J. G., Milano, C. A., Velazquez, E. J., & Khouri, M. G. (2017). Assessment of cardiac allograft systolic function by global longitudinal strain: From donor to recipient. Clinical Transplantation, 31(5), [e12961]. https://doi.org/10.1111/ctr.12961