Abstract
Endomyocardial biopsy is the gold standard for determining rejection; however, no echocardiographic indexes have been widely accepted as indicators of rejection. The stress-velocity relation of corrected velocity of circumferential fiber shortening to wall stress is a preload independent index of contractility that incorporates afterload and has been shown to distinguish a decreased velocity caused by excess afterload from that caused by decreased contractility. Wall stress has not been previously reported as a determinant of rejection. We report a prospective double-blind study of pediatric cardiac transplant patients comparing biopsy and quantitative systolic echocardiographic data. Thirty-two pediatric patients underwent 67 biopsies. At the time of catheterization, an echocardiographic evaluation was performed. Standard measurements of systolic function were collected and left ventricular (LV) fractional shortening, LV volume, LV mass, velocity of circumferential fiber shortening, and estimated end-systolic wall stress were calculated. In evaluating echocardiographic data of patients with and without biopsy-proven rejection, we were unable to identify any significant correlation between any systolic echocardiographic parameter and rejection. We conclude that: (1) the stress-velocity relation does not detect myocardial rejection; and (2) neither LV fractional shortening, LV volume, nor LV mass detect rejection; and (3) central venous pressure influence wall stress values significantly.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.