Journal of the American Society of Echocardiography
Echocardiography in ChildrenAltered Biatrial Phasic Function after Heart Transplantation in Children
Section snippets
Study Population
We prospectively enrolled pediatric subjects, status post–orthotopic HT and normal controls from September 2013 to October 2015 in two centers. Subjects were recruited consecutively during the study time period at routine outpatient clinic visits or at the time of surveillance biopsy. Any subjects with biopsy or clinically proven rejection at the time of recruitment or baseline LV ejection fraction <55% (based on review of clinical reports) were excluded. Demographic data including age, height,
Results
The 86 subjects consisted of 50 normal controls (mean age 8.9 ± 5.6 years, 26/24 male/female) and 36 HT patients (mean age 10.2 ± 6.2 years, 16/20 male/female, and 55 examinations). No significant differences in age were observed between the controls and HT groups (P = .32). Additionally, within the HT group, no significant differences were observed between donor age and recipient age at transplant (P = .14). Follow-up examinations of the HT patients were excluded from the primary analysis, and
Discussion
We investigated the phasic function of the RA and LA using two-dimensional speckle-tracking echocardiography (2D-STE) in the transplanted pediatric heart relative to that of normal controls. Analysis was feasible in all but two of the 86 subjects with acceptable inter- and intraobserver variability.
Conclusion
Pediatric HT recipients had altered atrial mechanics up to 5 years after HT, indicating that the reservoir, conduit, and booster function of both atria may be measurably disrupted by implantation into the recipient. Atrial strain determination is feasible in pediatric HT and shows potential as a means for monitoring trends in ventricular diastolic function in this population. Larger, longitudinal studies are needed to determine whether these abnormalities in atrial function are predictive of
Acknowledgment
We thank Berthold Klas, MS, from TomTec Imaging Systems for technical support.
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Conflicts of Interest: None.