Ran Hong, Zhang Ping-Yang, Ma Xiao-Wu, Dong Jing, Wu Wen-Fang
Department of Echocardiography, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
J Card Surg. 2020 Apr;35(4):755-763. doi: 10.1111/jocs.14461. Epub 2020 Feb 12.
We try to investigate whether the values of longitudinal strain present differences between the left and right ventricles in long-time follow-ups after heart transplantation (HTx) with dynamic changes in function.
Follow-up transthoracic echocardiography was performed in 1- and 3-month and 1- and 5-year follow-ups in 50 "healthy" HTx patients and compared with 26 control subjects. The left ventricle with preserved ejection fraction evaluated by biplane Simpson (control group [CG] vs HT; P > .05) had an obvious reduction in global (CG: -20.49 ± 2.38 vs heart transplant 1 month [HT1m]: -13.06 ± 2.86, heart transplant 3 month [HT3m]: -13.61 ± 2.61, heart transplant 1 year [HT1y]: -13.69 ± 4.56, heart transplant 5 year [HT5y]: -14.41 ± 4.54; P < .001) and horizontal segmental (basal, mid, apical) (P < .001) together with chamber segmental (apical 4-chamber, apical 3-chamber, apical 2-chamber) (P < .001) average strain values. The right ventricle with reduced ventricular function measured by tissue Doppler imaging S' and tricuspid annular plane systolic excursion had a more distinctive reduction in global (CG: -24.53 ± 4.20 vs HT1m: -12.94 ± 5.03, HT3m: -13.68 ± 4.35, HT1y: -14.95 ± 7.50, HT5y: -15.20 ± 6.15; P < .001) with segmental lateral (P < .001) strain values. There were not any significant changes between 1- and 3-month follow-ups of all the values (P > .05). But it could be seen that values increased in 1- and 5-year follow-ups compared with the baseline of 1- and 3-month follow-ups (P < .05). The global and segmental strain of the right ventricle decreased more than that of the left ventricle in all HTx groups, and the strain values were decreased in the HTx groups compared with the CG, with the global decreased change rates being 11%, 10%, 6%, and 8%, respectively.
The strain values decreased after HTx and almost remained stable in the long-time follow-ups. Compared with the CG in both ventricles, they were with preserved or reduced functions. In addition, the deformation values of the right ventricle decreased more than those of the left.
我们试图研究心脏移植（HTx）术后长期随访中左心室和右心室纵向应变值是否存在差异，以及功能的动态变化情况。
对50例“健康”的HTx患者进行1个月、3个月、1年和5年的随访经胸超声心动图检查，并与26例对照受试者进行比较。通过双平面辛普森法评估射血分数保留的左心室（对照组[CG]与HT组；P＞0.05），其整体（CG：-20.49±2.38 vs心脏移植1个月[HT1m]：-13.06±2.86，心脏移植3个月[HT3m]：-13.61±2.61，心脏移植1年[HT1y]：-13.69±4.56，心脏移植5年[HT5y]：-14.41±4.54；P＜0.001）、水平节段（基底、中间、心尖）（P＜0.001）以及腔室节段（心尖四腔心、心尖三腔心、心尖两腔心）（P＜0.001）的平均应变值明显降低。通过组织多普勒成像S'和三尖瓣环平面收缩期位移测量心室功能降低的右心室，其整体（CG：-24.53±4.20 vs HT1m：-12.94±5.03，HT3m：-13.68±4.35，HT1y：-14.95±7.50，HT5y：-15.20±6.15；P＜0.001）和节段外侧（P＜0.001）应变值有更明显的降低。所有值在1个月和3个月随访之间没有任何显著变化（P＞0.05）。但可以看出，与1个月和3个月随访的基线相比，1年和5年随访的值有所增加（P＜0.05）。在所有HTx组中，右心室的整体和节段应变比左心室降低得更多，与CG组相比，HTx组的应变值降低，整体降低变化率分别为11%、10%、6%和8%。
HTx术后应变值降低，在长期随访中几乎保持稳定。与两个心室的CG组相比，它们的功能保留或降低。此外，右心室的变形值比左心室降低得更多。
