Strain and strain rate imaging using speckle tracking in acute allograft rejection in children with heart transplantation.
Acute allograft rejection is a major cause of morbidity and mortality following heart transplantation. There is no reliable noninvasive test to diagnose rejection. We aimed to investigate the accuracy of strain by speckle tracking echocardiography in the detection of acute rejection. We identified acute rejection episodes in patients followed at a single transplant center. Data were collected at baseline, during rejection and two follow-up points. Peak systolic radial and circumferential strain at the level of papillary muscles and peak systolic longitudinal strain from apical four-chamber view were analyzed offline. ANOVA was used for comparison between groups. p value ≤0.05 was considered significant. Fifteen rejection episodes were identified. There were no differences in the fractional shortening, LV posterior wall thickness, E/A, septal E/E', septal S', lateral E/E', lateral S', or MPI during rejection, compared to baseline. There was a significant increase in the LV mass during a rejection episode (47.5 vs. 34.4 g/ht(2.7) [p = 0.03]). The peak systolic radial strain (18.3 vs. 26.5; p = 0.03), longitudinal strain (-11.7 vs. -14.6; p = 0.05), and circumferential strain (-14.4 vs. -21.7; p = 0.05) declined significantly during rejection. In conclusion, peak systolic radial, longitudinal and circumferential strain decline and LV mass increases during an episode of rejection.
['Sehgal|Swati|S|', 'Blake|Jennifer M|JM|', 'Sommerfield|Julie|J|', 'Aggarwal|Sanjeev|S|']
D000293:Adolescent D000328:Adult D000704:Analysis of Variance D009202:Cardiomyopathies D002648:Child D002675:Child, Preschool D004452:Echocardiography D005260:Female D006084:Graft Rejection D006333:Heart Failure D016027:Heart Transplantation D006352:Heart Ventricles D006801:Humans D007223:Infant D008297:Male D015203:Reproducibility of Results D012189:Retrospective Studies D016277:Ventricular Function, Left D055815:Young Adult
speckle tracking allograft rejection children heart transplant