Altered Biatrial Phasic Function after Heart Transplantation in Children.
Document Type
Article
Publication Date
9-1-2020
Identifier
DOI: 10.1016/j.echo.2020.04.029
Abstract
Purpose: We used two-dimensional echocardiographic speckle-tracking to investigate whether left and right atrial (LA and RA) phasic function in pediatric heart transplantation (HT) patients is altered and explored the relationship to HT-related clinical variables.
Methods: Eighty-six subjects (36 HT and 50 normal children) were prospectively enrolled in two centers. Clinical data included age at HT, bypass time, ischemia time, donor age, and incidence of rejection. Atrial deformation indices including strain and strain rates (SRs) were measured using two-dimensional echocardiographic speckle-tracking. Components of phasic atrial function-reservoir (εr, SRr), conduit (εcd, SRcd), and booster (εct, SRct) were calculated. Comparisons with controls were made using t test or Kruskal-Wallis test, and correlations to clinical variables were explored.
Results: The mean age and body surface area of HT subjects were 10.2 ± 6.2 years and 1.2 ± 0.6 m2, respectively. The mean heart rates were higher in HT (96 ± 18 vs 88 ± 21 in controls). There were reductions in RA and LA reservoir (εr, SRr), conduit (εcd, SRcd), and booster (εct, SRct) function in HT compared with controls. There was no relationship of LA and RA deformation indices with mean age at HT, bypass time, or ischemia time. The LA εcd correlated weakly with donor age (r = -0.49, P = .04) and RA SRr, and SRcd showed association with duration of HT (P < .05). Nineteen HT recipients had follow-up studies 0.24 ± 0.18 years after the first examination, and deformational indices were not significantly changed.
Conclusions: Atrial strain determination is feasible in pediatric HT recipients and demonstrates disruption of reservoir, conduit, and booster function of both atria in this population; we speculate this may be a consequence of ventricular diastolic dysfunction.
Journal Title
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
Volume
33
Issue
9
First Page
1132
Last Page
1140
Keywords
Atrial strain; Atrial strain rate; Heart transplantation; Pediatric cardiology; Two-dimensional speckle-tracking
Recommended Citation
Parthiban A, Jani V, Zhang J, et al. Altered Biatrial Phasic Function after Heart Transplantation in Children. J Am Soc Echocardiogr. 2020;33(9):1132-1140.e2. doi:10.1016/j.echo.2020.04.029
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