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Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients

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Abstract

The purpose of the study is to determine the association of Doppler Tissue Imaging (DTI) and catheter-derived measures with rejection in pediatric heart transplant (PHT) recipients and to determine any correlation between DTI and catheter-derived measurements. Sixty echocardiograms were prospectively performed in 37 PHT recipients at the time of surveillance cardiac biopsy. During right-heart cardiac catheterization, sequential pressures of the right heart and pulmonary capillary wedge pressures (PCWP) were measured. DTI was performed to obtain peak systolic (S’), early (E’) and late (A’) diastolic velocities (cm/s) at tricuspid annulus, septum and mitral annulus. Septal S’ and tricuspid annular A’ were associated with rejection, but had low sensitivity and specificity. Elevated lateral mitral E/E’ did not predict rejection. The mean pulmonary capillary wedge pressure (PCWP) and cardiac index were similar in those with and without rejection. The lateral mitral and septal E/E’ did not correlate with PCWP. Some DTI-derived measures were altered during rejection, but were not clinically useful predictors of rejection. Catheter-derived measures were not significantly altered during rejection and did not correlate with DTI-derived measures. None of these measures can replace the current practice of performing cardiac biopsy for surveillance of rejection.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Cardiology, Arkansas Children’s Hospital and University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Ritu Sachdeva, Sadia Malik, Paul M. Seib & Elizabeth A. Frazier

  2. Arkansas Center for Birth Defects Research and Prevention, Arkansas Children’s Hospital and University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Sadia Malik & Mario A. Cleves

  3. Arkansas Children’s Hospital, 1900 Maryland, Slot 512-3, Little Rock, AR, 72202, USA

    Ritu Sachdeva

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  1. Ritu Sachdeva
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  2. Sadia Malik
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  4. Elizabeth A. Frazier
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  5. Mario A. Cleves
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Correspondence to Ritu Sachdeva.

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Sachdeva, R., Malik, S., Seib, P.M. et al. Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients. Int J Cardiovasc Imaging 27, 947–954 (2011). https://doi.org/10.1007/s10554-010-9747-4

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  • DOI: https://doi.org/10.1007/s10554-010-9747-4

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