Preoperative echocardiographic parameters predict primary graft dysfunction following pediatric lung transplantation.
Adolescent
Area Under Curve
Child
Child, Preschool
Echocardiography
Female
Humans
Logistic Models
Lung Transplantation
Male
Outcome Assessment, Health Care
Pilot Projects
Preoperative Period
Primary Graft Dysfunction
/ diagnosis
ROC Curve
Retrospective Studies
Risk Factors
Ventricular Dysfunction
/ complications
left ventricular diastolic function
lung transplantation
pediatric
primary graft dysfunction
pulmonary hypertension
right ventricular systolic function
strain echocardiography
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
15
05
2020
revised:
13
08
2020
accepted:
02
09
2020
pubmed:
20
10
2020
medline:
5
1
2022
entrez:
19
10
2020
Statut:
ppublish
Résumé
The importance of preoperative cardiac function in pediatric lung transplantation is unknown. We hypothesized that worse preoperative right ventricular (RV) systolic and worse left ventricular (LV) diastolic function would be associated with a higher risk of primary graft dysfunction grade 3 (PGD 3) between 48 and 72 hours. We performed a single center, retrospective pilot study of children (<18 years) who had echocardiograms <1 year prior to lung transplantation between 2006 and 2019. Conventional and strain echocardiography parameters were measured, and PGD was graded. Area under the receiver operating characteristic (AUROC) curves and logistic regression were performed. Forty-one patients were included; 14 (34%) developed PGD 3 and were more likely to have pulmonary hypertension (PH) as the indication for transplant (P = .005). PGD 3 patients had worse RV global longitudinal strain (P = .01), RV free wall strain (FWS) (P = .003), RV fractional area change (P = .005), E/e' (P = .01) and lateral e' velocity (P = .004) but not tricuspid annular plane systolic excursion (P = .61). RV FWS (AUROC 0.79, 95% CI 0.62-0.95) and lateral e' velocity (AUROC 0.87, 95% CI 0.68-1.00) best discriminated PGD 3 development and showed the strongest association with PGD 3 (RV FWS OR 3.87 [95% CI 1.59-9.43], P = .003; lateral e' velocity OR 0.10 [95% CI 0.01-0.70], P = .02). These associations remained when separately adjusting for age, weight, primary PH diagnosis, ischemic time, and bypass time. In this pilot study, worse preoperative RV systolic and worse LV diastolic function were associated with PGD 3 and may be modifiable recipient risk factors in pediatric lung transplantation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13858Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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