Abstract 14017: Right Ventricular Morphology and Function in Heart Transplant Recipients
Background. The right heart is a major determinant of prognosis in cardiac transplant recipient patients (CTp).
Aim: To investigate right ventricular (RV) morphology and function in CTp.
Methods: 85 CTp (54 males; 58.3±10.8 years) and 40 healthy age- and sex-comparable controls underwent Tissue Doppler Imaging (TDI), two-dimensional strain imaging (2DSE) and 3D echocardiography. Along with left heart parameters, RV measurements included: end-diastolic diameters at basal (RVD1) and mid-cavity (RVD2) ; base-to-apex length (RVD3), tricuspid annular plane systolic excursion (TAPSE), TDI RV systolic peak velocity (Sm), global strain and 3D ejection fraction (EF). Pulmonary artery systolic (PASP) was calculated by the tricuspid regurgitation velocity (TRV). Left ventricular stroke volume (LVSV) was obtained using the volumetric flow through the LV outflow tract. Pulmonary artery vascular compliance (PAVC) was finally estimated by LVSV/4 x (TRV2 - pulmonary regurgitation velocity2 ).
Results: RV diameters were significantly increased, while TAPSE and RV Sm were significantly lower in CTp. Conversely, both RV global longitudinal strain and 3DRVEF were not significantly impaired in CTp. In a subgroup of 30 CTp , a close correlation was observed between 3D and magnetic resonance assessment of RVEF (p<0.0001). Both PASP and PAVC were impaired in CTp. By multivariable analysis, age (p<0.01) and PAVC (p<0.001) were the only independent determinants of RV strain and EF in CTp.
Conclusion: Despite the reduction of RV performance suggested by TAPSE and RV Sm, the increased RV diameters along with absence of a decrease in RV global strain and in 3D RVEF, support the hypothesis of geometrical rather than functional changes of RV. .
- © 2011 by American Heart Association, Inc.