Detection of cardiac allograft vasculopathy by multi-layer left ventricular longitudinal strain in heart transplant recipients.
Coronary allograft vasculopathy
Heart transplant
Speckle tracking echocardiography
Journal
The international journal of cardiovascular imaging
ISSN: 1875-8312
Titre abrégé: Int J Cardiovasc Imaging
Pays: United States
ID NLM: 100969716
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
11
10
2020
accepted:
24
12
2020
pubmed:
15
1
2021
medline:
16
10
2021
entrez:
14
1
2021
Statut:
ppublish
Résumé
Cardiac allograft vasculopathy (CAV) is an obliterative and diffuse type of coronaropathy that develops in the transplanted human heart, representing a major cause of graft failure and mortality. Nowadays the gold standard for the diagnosis of CAV is coronary angiography (CA). Non-invasive CAV detection, especially in the early stages of the disease, is still challenging. Our study aimed to investigate the role of speckle tracking echocardiography (STE), in particular three-layer STE, in predicting CAV at early stages, and if other traditional echocardiographic, clinical or biochemical parameters could relate to CAV. The study population was composed of a total of 33 heart transplanted patients, divided accordingly to the presence or absence of CAV (12 CAV+ , 22 CAV-). All subjects underwent a complete transthoracic echocardiographic examination on the same day of the CA, and all conventional parameters of myocardial function were obtained, including strain values assessed by STE. Strain values were significantly reduced in presence of CAV, at each myocardial layer but in particular the endocardial-epicardial gradient (- 4.15 ± 1.6 vs - 1.7 ± 0.4% < .0001) that was also highly predictive of CAV (AUC at ROC curve 0.97). Among diastolic parameters, the E wave deceleration time (DT) and the mean E/e' ratio were strongly positively associated with CAV. In our population, left ventricular global longitudinal strain (GLS), layer-specific GLS and the endocardial-epicardial LS gradient, E wave DT and E/e' ratio were the best independent non-invasive predictors of CAV.
Identifiants
pubmed: 33442856
doi: 10.1007/s10554-020-02147-2
pii: 10.1007/s10554-020-02147-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1621-1628Références
Chang DH, Kobashigawa JA (2015) Current diagnostic and treatment strategies for cardiac allograft vasculopathy. Expert Rev Cardiovasc Ther 13:1147–1154
pubmed: 26401922
doi: 10.1586/14779072.2015.1087312
Sipahi I, Starling RC (2007) Cardiac allograft vasculopathy: an update. Heart Fail Clin 3:87–95
pubmed: 17545012
doi: 10.1016/j.hfc.2007.02.007
Morisco C, Barbato E (2019) From microvascular impairment to cardiac allograft vasculopathy: a disease continuum. Int J Cardiol 290:33
pubmed: 31126733
doi: 10.1016/j.ijcard.2019.05.022
Mehra MR, Crespo-Leiro MG, Dipchand A et al (2010) International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy–2010. J Heart Lung Transplant 29:717–727
pubmed: 20620917
doi: 10.1016/j.healun.2010.05.017
Costanzo MR, Dipchand A, Starling R et al (2010) The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant 29:914–956
pubmed: 20643330
pmcid: 20643330
doi: 10.1016/j.healun.2010.05.034
Dedieu N, Silva Vieira M, Fenton M, Wong J, Botnar R, Burch M, Greil G, Hussain T (2018) The importance of qualitative and quantitative regional wall motion abnormality assessment at rest in pediatric coronary allograft vasculopathy. Pediatr Transplant Pediatr Transplant 22:e13208
pubmed: 29733526
doi: 10.1111/petr.13208
Erbel C, Mukhammadaminova N, Gleissner CA, Osman NF, Hofmann NP, Steuer C, Akhavanpoor M, Wangler S, Celik S, Doesch AO, Voss A, Buss SJ, Schnabel PA, Katus HA, Korosoglou G (2016) Myocardial perfusion reserve and strain-encoded CMR for evaluation of cardiac allograft microvasculopathy. JACC Cardiovasc Imaging 9:255–266
pubmed: 26965729
doi: 10.1016/j.jcmg.2015.10.012
Shenoy C, Romano S, Hughes A, Okasha O, Nijjar PS, Velangi P, Martin CM, Akçakaya M, Farzaneh-Far A (2020) Cardiac magnetic resonance feature tracking global longitudinal strain and prognosis after heart transplantation. JACC Cardiovasc Imaging 13:1934–1942
pubmed: 32563650
doi: 10.1016/j.jcmg.2020.04.004
Eleid MF, Caracciolo G, Cho EJ et al (2010) Natural history of left ventricular mechanics in transplanted hearts: relationships with clinical variables and genetic expression profiles of allograft rejection. J Am Coll Cardiol Img 3:989–1000
doi: 10.1016/j.jcmg.2010.07.009
Sato T, Kato TS, Kamamura K et al (2011) Utility of left ventricular systolic torsion derived from 2-dimensional speckle-tracking echocardiography in monitoring acute cellular rejection in heart transplant recipients. J Heart Lung Transplant 30:536–543
pubmed: 21183361
doi: 10.1016/j.healun.2010.10.014
Mingo-Santos S, Moñivas-Palomero V, Garcia-Lunar I et al (2015) Usefulness of two-dimensional strain parameters to diagnose acute rejection after heart transplantation. J Am Soc Echocardiogr 28:1149–1156
pubmed: 26165446
doi: 10.1016/j.echo.2015.06.005
Clemmensen TS, Løgstrup BB, Eiskjær H, Poulsen SH (2015) Evaluation of longitudinal myocardial deformation by 2-dimensional speckle-tracking echocardiography in heart transplant recipients: relation to coronary allograft vasculopathy. J Heart Lung Transplant 34(2):195–203
pubmed: 25108908
doi: 10.1016/j.healun.2014.07.008
Clemmensen TS, Eiskjær H, Løgstrup BB, Tolbod LP, Harms HJ, Bouchelouche K, Hoff C, Frøkiær J, Poulsen SH (2016) Noninvasive detection of cardiac allograft vasculopathy by stress exercise echocardiographic assessment of myocardial deformation. J Am Soc Echocardiogr 29:480–490
pubmed: 26898523
doi: 10.1016/j.echo.2016.01.012
Ghali MCZ, Stewart R, Ghali GZ, Blitzer W (2020) Two dimensional speckle tracking echocardiography detects cardiac allograft stage III vasculopathy in recipients of heart transplants with preserved systolic function. Acta Cardiol 31:1–11
doi: 10.1080/00015385.2020.1800963
Dandel M, Lehmkuhl H, Knosalla C, Grauhan O, Weng Y, Pasic M, Hetzer R (2008) Echocardiographic 2D-strain imaging for early detection of patients with focal coronary stenoses after heart transplantation. J Heart Lung Transplant 27(2 Suppl 1):S95-96
doi: 10.1016/j.healun.2007.11.108
Logstrup BB, Hofsten DE, Christophersen TB et al (2012) Correlation between left ventricular global and regional longitudinal systolic strain and impaired microcirculation in patients with acute myocardial infarction. Echocardiography 10:1181–1190
doi: 10.1111/j.1540-8175.2012.01784.x
Mizuguchi Y, Oishi Y, Miyoshi H, Iuchi A, Nagase N, Oki T (2008) The functional role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with two-dimensional strain imaging. J Am Soc Echocardiogr 21:1138–1144
pubmed: 18926389
doi: 10.1016/j.echo.2008.07.016
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1-39.e14
doi: 10.1016/j.echo.2014.10.003
Olymbios M, Kwiecinski J, Berman DS, Kobashigawa JA (2018) Imaging in heart transplant patients. JACC Cardiovasc Imaging 11(10):1514–1530
pubmed: 30286911
doi: 10.1016/j.jcmg.2018.06.019
Cohn JM, Wilensky RL, O’Donnell JA, Bourdillon PDV, Dillon JC, Feigenbaum H (1996) Exercise echocardiography, angiography, and intracoronary ultrasound after cardiac transplantation. Am J Cardiol 77:1216–1219
pubmed: 8651098
doi: 10.1016/S0002-9149(96)00165-8
Akosah KO, Mohanty PK, Funai JT et al (1994) Noninvasive detection of transplant coronary artery disease by dobutamine stress echocardiography. J Heart Lung Transplant 13:1024–1038
pubmed: 7865509
Derumeaux G, Redonnet M, Soyer R, Cribier A, Letac B (1998) Assessment of the progression of cardiac allograft vasculopathy by dobutamine stress echocardiography. J Heart Lung Transplant 17:259–267
pubmed: 9563602
Chirakarnjanakorn S, Starling RC, Popovic ZB, Griffin BP, Desai MY (2015) Dobutamine stress echocardiography during follow-up surveillance in heart transplant patients: diagnostic accuracy and predictors of outcomes. J Heart Lung Transplant 34:710–717
pubmed: 25682552
doi: 10.1016/j.healun.2014.11.019
Clerkin KJ, Farr MA, Restaino SW, Ali ZA, Mancini DM (2016) Dobutamine stress echocardiography is inadequate to detect early cardiac allograft vasculopathy. J Heart Lung Transplant 35:1040–1041
pubmed: 27318788
pmcid: 5653920
doi: 10.1016/j.healun.2016.05.012
Dandel M, Hetzer R (2017) Post-transplant surveillance for acute rejection and allograft vasculopathy by echocardiography: usefulness of myocardial velocity and deformation imaging. J Heart Lung Transplant 36:117–131
pubmed: 27876281
doi: 10.1016/j.healun.2016.09.016
Cameli M, Mandoli GE, Sciaccaluga C, Mondillo S (2019) More than 10 years of speckle tracking echocardiography: still a novel technique or a definite tool for clinical practice? Echocardiography 36(5):958–970
pubmed: 30974002
doi: 10.1111/echo.14339
Choi JO, Cho SW, Song YB, Cho SJ, Song BG, Lee SC, Park SW (2009) Longitudinal 2D strain at rest predicts the presence of left main and three vessel coronary artery disease in patients without regional wall motion abnormality. Eur J Echocardiogr 10(5):695–701
pubmed: 19401300
doi: 10.1093/ejechocard/jep041
Biering-Sorensen T, Hoffmann S, Mogelvang R, Zeeberg Iversen A, Galatius S, Fritz-Hansen T, Bech J, Jensen JS (2014) Myocardial strain analysis by 2-dimensional speckle tracking echocardiography improves diagnostics of coronary artery stenosis in stable angina pectoris. Circ Cardiovasc Imaging 7(1):58–65
pubmed: 24186963
doi: 10.1161/CIRCIMAGING.113.000989
Shimoni S, Gendelman G, Ayzenberg O, Smirin N, Lysyansky P, Edri O, Deutsch L, Caspi A, Friedman Z (2011) Differential effects of coronary artery stenosis on myocardial function: the value of myocardial strain analysis for the detection of coronary artery disease. J Am Soc Echocardiogr 24(7):748–757
pubmed: 21511433
doi: 10.1016/j.echo.2011.03.007
Nucifora G, Schuijf JD, Delgado V, Bertini M, Scholte AJ, Ng AC, van Werkhoven JM, Jukema JW, Holman ER, van der Wall EE, Bax JJ (2010) Incremental value of subclinical left ventricular systolic dysfunction for the identification of patients with obstructive coronary artery disease. Am Heart J 159(1):148–157
pubmed: 20102881
doi: 10.1016/j.ahj.2009.10.030
Myers JH, Stirling MC, Choy M, Buda AJ, Gallagher KP (1986) Direct measurement of inner and outer wall thickening dynamics with epicardial echocardiography. Circulation 74(1):164–172
pubmed: 3708771
doi: 10.1161/01.CIR.74.1.164
Sabbah HN, Marzilli M, Stein PD (1981) The relative role of subendocardium and subepicardium in left ventricular mechanics. Am J Physiol 240(6):H920–H926
pubmed: 7246754
Kim SA, Park SM, Kim MN, Shim WJ (2016) Assessment of left ventricular function by layer-specific strain and its relationship to structural remodelling in patients with hypertension. Can J Cardiol 32(2):211–216
pubmed: 26255215
doi: 10.1016/j.cjca.2015.04.025
Sarvari SI, Haugaa KH, Zahid W, Bendz B, Aakhus S, Aaberge L, Edvardsen T (2013) Layer-specific quantification of myocardial deformation by strain echocardiography may reveal significant CAD in patients with non-ST-segment elevation acute coronary syndrome. JACC Cardiovasc Imaging 6(5):535–544
pubmed: 23582354
doi: 10.1016/j.jcmg.2013.01.009
Zhang L, Wu WC, Ma H, Wang H (2016) Usefulness of layer-specific strain for identifying complex CAD and predicting the severity of coronary lesions in patients with non-ST-segment elevation acute coronary syndrome: compared with Syntax score. Int J Cardiol 223:1045–1052
pubmed: 27592047
doi: 10.1016/j.ijcard.2016.08.277
Leitman M, Lysiansky M, Lysyansky P, Friedman Z, Tyomkin V, Fuchs T, Adam D, Krakover R, Vered Z (2010) Circumferential and longitudinal strain in 3 myocardial layers in normal subjects and in patients with regional left ventricular dysfunction. J Am Soc Echocardiogr 23(1):64–70
pubmed: 20122496
doi: 10.1016/j.echo.2009.10.004
Chih S, Chong AY, Mielniczuk LM, Bhatt DL, Beanlands RS (2016) Allograft vasculopathy: the Achilles’ heel of heart transplantation. J Am Coll Cardiol 68(1):80–91
pubmed: 27364054
doi: 10.1016/j.jacc.2016.04.033
Weber BN, Kobashigawa JA, Givertz MM (2017) Evolving areas in heart transplantation. JACC Heart Fail 5(12):869–878
pubmed: 29191294
doi: 10.1016/j.jchf.2017.10.009
Cameli M, Sciaccaluga C, Loiacono F, Simova I, Miglioranza MH, Nistor D, Bandera F, Emdin M, Giannoni A, Ciccone MM, Devito F, Guaricci AI, Favale S, Lisi M, Mandoli GE, Henein M, Mondillo S (2019) The analysis of left atrial function predicts the severity of functional impairment in chronic heart failure: The FLASH multicenter study. Int J Cardiol 286:87–91
pubmed: 30955880
doi: 10.1016/j.ijcard.2019.03.063
Cameli M, Sciaccaluga C, Mandoli GE, D’Ascenzi F, Tsioulpas C, Mondillo S (2019) The role of the left atrial function in the surgical management of aortic and mitral valve disease. Echocardiography 36(8):1559–1565
pubmed: 31260141
doi: 10.1111/echo.14426
Sciaccaluga C, D’Ascenzi F, Mandoli GE, Rizzo L, Sisti N, Carrucola C, Cameli P, Bigio E, Mondillo S, Cameli M (2020) Traditional and Novel Imaging of Right Ventricular Function in Patients with Heart Failure and Reduced Ejection Fraction. Curr Heart Fail Rep 17(2):28–33
pubmed: 32130642
doi: 10.1007/s11897-020-00455-1
Badano LP, Miglioranza MH, Edvardsen T et al (2015) European Association of Cardiovascular Imaging/Cardiovascular Imaging Department of the Brazilian Society of Cardiology recommendations for the use of cardiac imaging to assess and follow patients after heart transplantation. Eur Heart J Cardiovasc Imaging 16:919–948
pubmed: 26139361
doi: 10.1093/ehjci/jev139
Lopez B, Sanchez V, Delgado JF et al (2012) Accuracy of noninvasive estimation of pulmonary wedge pressure by echocardiographic indices in heart transplant recipients. Transplant Proc 44:2639–2641
pubmed: 23146480
doi: 10.1016/j.transproceed.2012.09.058