Fu Shengyi, Patel Aditi G M, Ruzieh Mohammed, Hanayneh Seri, Vilaro Juan, Ahmed Mustafa M, Aranda Juan M, Parker Alex M, Bleiweis Mark S, Jacobs Jeffrey P, Al-Ani Mohammad A
College of Medicine, University of Florida, Gainesville, FL, United States of America.
Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
Am Heart J Plus. 2024 Jul 27;45:100428. doi: 10.1016/j.ahjo.2024.100428. eCollection 2024 Sep.
Cardiac allografts suffer diastolic dysfunction early post-heart transplantation (HTx) due to ischemic injury, however the natural course of diastology recovery post HTx remains unknown (Tallaj et al., 2007 [1]). We retrospectively reviewed 60 adult HTx patients between 2015 and 2021 at a single site. Invasive hemodynamics and echocardiograms were obtained at 2 weeks and 1, 3, 6, and 12 months post-HTx. RA strain by 2D feature tracking was compared to intracardiac pressure measurements. In all patients, we observed normalization of RV and RA filling pressures by post-operative week 12 and recovery of diastolic dysfunction by month 6. There was an inverse correlation between RV end-diastolic pressure and RA contractile ( = -0.192, < 0.05) and reservoir ( = -0.128, p < 0.05) functions in the allograft. As the post-transplant care paradigm shifts away from invasive procedures, right atrial indices should be included in imaging-based allograft surveillance studies.
心脏同种异体移植在心脏移植（HTx）后早期会因缺血性损伤而出现舒张功能障碍，然而HTx后舒张功能恢复的自然病程仍不清楚（塔拉伊等人，2007年[1]）。我们回顾性分析了2015年至2021年间在单一中心的60例成年HTx患者。在HTx后2周以及1、3、6和12个月时进行有创血流动力学检查和超声心动图检查。通过二维特征跟踪获得的右心房应变与心内压力测量结果进行比较。在所有患者中，我们观察到术后第12周时右心室和右心房充盈压恢复正常，舒张功能障碍在第6个月时恢复。同种异体移植物中右心室舒张末期压力与右心房收缩功能（r = -0.192，p < 0.05）和储备功能（r = -0.128，p < 0.05）呈负相关。随着移植后护理模式从侵入性操作转变，基于成像的同种异体移植物监测研究应纳入右心房指标。
