Abstract 14755: Left Ventricular Three-Dimensional Speckle Tracking Echocardiography Predicts Adverse Clinical Outcomes in Heart Transplant Patients

Abstract

Background: The prognostic value of 3D-GLS in HT recipients has not been evaluated. This study explored the long-term prognostic significance of 3D-GLS in HT recipients. Methods: The study comprised 296 consecutive patients who underwent HT between January 2015 and December 2019 at Union Hospital in Wuhan, China. All subjects underwent comprehensive transthoracic two-dimensional (2D) and 3D echocardiographic examinations. Patients were followed until January 1st, 2022. Major adverse cardiac events (MACE) were defined as a composite of heart failure hospitalization, re-transplantation and death. Results: After a median follow-up of 3.3 years, 53 HT patients experienced MACE. Patients with MACE displayed significantly impaired 2D-GLS and 3D-GLS compared with those without MACE. Kaplan-Meier analysis showed that the risk of MACE increased significantly with worsening tertiles of 2DGLS and 3DGLS (both log-rank p < 0.001). Area under the curve for 3D-GLS was larger than that in 2D-GLS for MACE prediction. On multivariate Cox proportional hazards regression, 2D-GLS and 3D-GLS were independently associated with the MACE after adjustment for diabetes, history of rejection, hemoglobin, brain natriuretic peptide (BNP), and LV ejection fraction. In addition, 3D-GLS provided incremental prognostic value over 2D-GLS. Continuous net reclassification improvement analysis showed an improvement of + 23.3% was noted in the accuracy of classification between 3D-GLS and 2D-GLS. Conclusion: In heart transplant recipients, 3D-GLS is an independently predictor of MACE. These findings support the potential of 3D-GLS to identify higher risk HT patients.