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Serial changes of right ventricular function assessed by three-dimensional speckle-tracking echocardiography in clinically well adult heart transplantation patients

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Abstract

Purpose

The present study aimed to evaluate serial changes of right ventricular (RV) function in clinically well adult heart transplantation (HT) patients using three-dimensional speckle-tracking echocardiography (3D-STE).

Methods

We included 58 adult HT patients, who were free from severe valvular insufficiency, severe coronary artery disease, acute rejection, or multiple organ transplantation, and 58 healthy controls. The healthy controls were matched by the distribution of age and sex with HT group. Conventional and three-dimensional (3D) echocardiography was performed in all HT patients at 1-, 3-, 6-, 9- and 12-months post-HT. And all the healthy controls underwent conventional and 3D echocardiography when recruited. Tricuspid annular plane systolic excursion (TAPSE), S’ and RV fractional area change (RV FAC) were measured. Two-dimensional RV free wall longitudinal strain (2D-RV FWLS) was derived from two-dimensional speckle-tracking echocardiography (2D-STE). 3D RV free wall longitudinal strain (3D-RV FWLS) and RV ejection fraction (RVEF) were assessed by 3D-STE.

Results

TAPSE, S’, RV FAC, 2D-RV FWLS, 3D-RV FWLS, and RVEF increased significantly from 1 to 6 months post-HT (P < 0.05). TAPSE, S’, RV FAC and 2D-RV FWLS showed no significant changes from 6 to 12 months post-HT (P > 0.05), while 3D-RV FWLS and RVEF were still significantly increased: 3D-RV FWLS (17.9 ± 1.0% vs. 18.7 ± 1.4%, P < 0.001) and RVEF (45.9 ± 2.2% vs. 46.8 ± 2.0%, P = 0.025). By 12 months post-HT, TAPSE, S’, RV FAC, 2D-RV FWLS, 3D-RV FWLS and RVEF were significantly lower than the healthy controls: TAPSE (15.1 ± 2.1 mm vs. 23.5 ± 3.0 mm, P < 0.001), s’ (10.3 ± 1.9 cm/s vs. 12.9 ± 2.0 cm/s, P < 0.001), RV FAC (45.3 ± 1.8% vs. 49.2 ± 3.8%, P < 0.001), 2D-RV FWLS (19.9 ± 2.3% vs. 23.5 ± 3.8%, P < 0.001), 3D-RV FWLS (18.7 ± 1.4% vs. 22.4 ± 2.3%, P < 0.001) and RVEF (46.8 ± 2.0% vs. 49.9 ± 5.7%, P < 0.001).

Conclusion

RV systolic function improved significantly over time in clinically well adult HT patients even up to 12 months post-HT. By 12 months post-HT, the patient's RV systolic function remained lower than the control. 3D-STE may be more suitable to assess RV systolic function in HT patients.

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Funding

This work was supported by the National Natural Science Foundation of China [Grant Numbers 81922033, 81727805, 81530056].

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Author notes

  1. Meng Li and Qing Lv have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, 430022, China

    Qing Lv, Yanting Zhang, Wei Sun, Chun Wu, Yiwei Zhang, Shuangshuang Zhu, He Li, Yuman Li, Li Zhang & Mingxing Xie

  2. Department of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, People’s Republic of China; Shanghai Institute of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People’s Republic of China

    Meng Li

  3. Hubei Province Clinical Research Center for Medical Imaging, Wuhan, 430022, China

    Qing Lv, Yanting Zhang, Wei Sun, Chun Wu, Yiwei Zhang, Shuangshuang Zhu, He Li, Yuman Li, Li Zhang & Mingxing Xie

  4. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China

    Qing Lv, Yanting Zhang, Wei Sun, Chun Wu, Yiwei Zhang, Shuangshuang Zhu, He Li, Yuman Li, Li Zhang & Mingxing Xie

  5. Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Nianguo Dong

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  1. Meng Li
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Contributions

Conception and design of the study: QL, ML, YL, LZ, MX Acquisition of data: ML, YZ, WS, YZ, SZ, HL, CW. Analysis and interpretation of data: ML, YZ, WS, YZ, HL, CW. Drafting the article: QL, ML. Revising the article: QL, ML, ND, YL, LZ, MX. Final approval of the article: QL, ML, YZ, WS, YZ, CW, SZ, HL, ND, YL, LZ, MX.

Corresponding authors

Correspondence to Yuman Li, Li Zhang or Mingxing Xie.

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Li, M., Lv, Q., Zhang, Y. et al. Serial changes of right ventricular function assessed by three-dimensional speckle-tracking echocardiography in clinically well adult heart transplantation patients. Int J Cardiovasc Imaging 39, 725–736 (2023). https://doi.org/10.1007/s10554-022-02778-7

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