Abstract
Transthoracic echocardiography is the primary non-invasive modality for the investigation of heart transplant recipients. It is a versatile tool that provides comprehensive information on cardiac structure and function. Echocardiography is also helpful in diagnosing primary graft dysfunction and evaluating the effectiveness of therapeutic approaches for this condition. In acute rejection, echocardiography is useful with suspected cellular or antibody-mediated rejection, with findings confirmed and quantified by endomyocardial biopsy. For identifying chronic rejection, ultrasound has a more significant role and, in some specific patients (e.g., patients with renal failure), it may offer a role comparable to coronary angiography to identify cardiac allograft vasculopathy. This review highlights the usefulness of echocardiography in evaluating normal graft function and its role in the management of heart transplant recipients.
Highlights
Heart transplantation remains the gold-standard therapy for patients with advanced heart failure despite optimal medical treatment [1]
Over the past four decades, remarkable advances in diagnostic methods for early identification of acute and chronic rejection and in immunosuppressive therapy have resulted in a marked increase in long-term survival, with a current one-year survival rate after heart transplantation of 90% and a conditional half-life of over 13 years [2]
Echocardiography is a fundamental tool for adequately managing heart transplant recipients (HTRs), from monitoring the immediate post-operative period to surveillance of early and late post-transplant complications [3]
Summary
Heart transplantation remains the gold-standard therapy for patients with advanced heart failure despite optimal medical treatment [1]. Over the past four decades, remarkable advances in diagnostic methods for early identification of acute and chronic rejection and in immunosuppressive therapy have resulted in a marked increase in long-term survival, with a current one-year survival rate after heart transplantation of 90% and a conditional half-life of over 13 years [2]. Echocardiography is a fundamental tool for adequately managing heart transplant recipients (HTRs), from monitoring the immediate post-operative period to surveillance of early and late post-transplant complications [3]. This review summarizes the basic principles for using echocardiography in cardiac transplant patients to allow even cardiologists not experienced in transplantation to apply this technology in the management of HTR correctly
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