Abstract
Purpose: Our objective is to describe normal values of right ventricular systolic function echocardiographic parameters, evaluated by means of conventional and two-dimensional speckle tracking echocardiography (2DSTE) in the first year after heart transplantation (HT), in the absence of acute cellular rejection. Methods: From September 1st, 2009 to December 14th, 2010 we performed an exhaustive echocardiographic exam in all transplant recipients during their first post-transplantation year within the same day of the routine endomyocardial biopsies. We selected the exams that were coincident with no acute cellular rejection (grade 0R). Tricuspid annular plane systolic excursion (TAPSE) measured with M-mode and 2DSTE, tricuspid annular lateral systolic velocity measured by Tissue Doppler Imaging (S' wave), right ventricular strain and strain rate, evaluated by means of 2DSTE, were obtained in all of them, and compared with 14 healthy controls. Results: 32 studies performed 4±3 months after heart transplantation in 14 patients showed absence of acute cellular rejection (grade 0R). The mean age was similar in donors and controls (35±14 versus 35±11, p=0,93) and higher in transplant recipients than in controls (50±15 versus 35±11, p=0,005). Male gender percentage was similar in donors versus controls (85% versus 71%, p=0,41) and in transplanted patients versus controls (93% versus 71%, p=0,14). Right ventricular function parameters in the transplanted group compared to controls were: TAPSE (M-mode) 15,7±2,7 versus 23,5±1,7 (p<0,0005), S' wave 11,8±1,8 versus 15,3±1,9 (p=0,005), TAPSE (2DSTE) 11,0±3,1 versus 21,2±3,6 (p<0,0005), right ventricular strain -25,1±9,2 versus -29,5±6,9 (p=0,29) and right ventricular strain rate -2,2±1,0 versus -2,9±1,7 (p=0,35). Conclusion: In the first year post-HT, and in the histologically proven absence of rejection, we found significantly lower values of TAPSE measured with M-mode and 2DSTE and S' wave in transplanted patients versus controls, and non-significantly lower values of right ventricular strain and strain rate, evaluated by means of 2DSTE.
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