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小儿心脏移植后左心室应变参数的变化

Changes in left ventricular strain parameters following pediatric heart transplantation.

作者信息

Godown Justin, Dodd Debra A, Stanley Michael, Havens Corey, Xu Meng, Slaughter James C, Bearl David W, Soslow Jonathan H

机构信息

Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN, USA.

Department of Biostatistics, Vanderbilt University, Nashville, TN, USA.

出版信息

Pediatr Transplant. 2018 Aug;22(5):e13166. doi: 10.1111/petr.13166. Epub 2018 Mar 25.

Abstract

STE is increasingly utilized to assess strain in a variety of pathologies. Strain measurements have demonstrated utility following HTx and may aid in the detection of rejection and CAV. Strain parameters have not been well defined in the pediatric HTx population. This study aimed to describe strain in pediatric HTx recipients compared to controls and assess changes over time. All pediatric HTx recipients with available echocardiograms (2004-2015) without rejection or CAV were identified. Longitudinal and circumferential strain was measured at <1 month, 1 year, 3 years, and 5 years post-transplant and compared to controls. A total of 218 echocardiograms were analyzed in 79 HTx recipients. At <1 month post-transplant, there was a significant decrement in longitudinal strain (GLS -14.6 vs -19.2, P < .001) with concurrent augmentation of circumferential strain (GCS -27.3 vs -24.3, P = .005). By 1 year post-HTx, all strain parameters normalized and were not significantly different from the control population. In the absence of graft complications, strain parameters did not change up to 5 years post-transplant. Abnormal longitudinal strain parameters are present in the early post-HTx period with a compensatory increase in circumferential strain. These changes normalize by 1 year post-transplant and do not change over time in the absence of graft complications.

摘要

斑点追踪成像(STE)越来越多地用于评估各种病理状态下的应变。应变测量已证明在心脏移植(HTx)后具有实用性,并可能有助于检测排斥反应和冠状动脉血管病变(CAV)。应变参数在儿科心脏移植人群中尚未得到很好的定义。本研究旨在描述儿科心脏移植受者与对照组相比的应变情况,并评估随时间的变化。确定了所有有可用超声心动图(2004 - 2015年)且无排斥反应或CAV的儿科心脏移植受者。在移植后<1个月、1年、3年和5年测量纵向和圆周应变,并与对照组进行比较。共对79名心脏移植受者的218份超声心动图进行了分析。移植后<1个月时,纵向应变显著降低(整体纵向应变[GLS] -14.6对 -19.2,P <.001),同时圆周应变增加(整体圆周应变[GCS] -27.3对 -24.3,P =.005)。到心脏移植后1年,所有应变参数均恢复正常,与对照组无显著差异。在没有移植物并发症的情况下,应变参数在移植后5年内没有变化。心脏移植术后早期存在纵向应变参数异常,圆周应变有代偿性增加。这些变化在移植后1年恢复正常,在没有移植物并发症的情况下不会随时间变化。

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