Background

Heart function following heart transplantation (HTx) is influenced by numerous factors. It is typically evaluated using transthoracic echocardiography, but reference values are currently unavailable for this context. The primary aim of the present study was to derive echocardiographic reference values for chamber size and function, including cardiac mechanics, in clinically stable HTx patients.

Methods

The study enrolled 124 healthy HTx patients examined prospectively. Patients underwent comprehensive two-dimensional echocardiographic examinations according to contemporary guidelines. Results were compared with recognized reference values for healthy subjects.

Results

Compared with guidelines, larger atrial dimensions were seen in HTx patients. Left ventricular (LV) diastolic volume was smaller, and LV wall thickness was increased. With respect to LV function, both ejection fraction (62 ± 7%, P < .01) and global longitudinal strain (−16.5 ± 3.3%, P < .0001) were lower. All measures of right ventricular (RV) size were greater than reference values (P < .0001), and all measures of RV function were reduced (tricuspid annular plane systolic excursion 15 ± 4 mm [P < .0001], RV systolic tissue Doppler velocity 10 ± 6 cm/sec [P < .0001], fractional area change 40 ± 8% [P < .0001], and RV free wall strain −16.9 ± 4.2% [P < .0001]). Ejection fraction and LV global longitudinal strain were significantly lower in patients with previous rejection.

Conclusion

The findings of this study indicate that the distribution of routinely used echocardiographic measures differs between stable HTx patients and healthy subjects. In particular, markedly larger RV and atrial volumes and mild reductions in both LV and RV longitudinal strain were evident. The observed differences could be clinically relevant in the assessment of HTx patients, and specific reference values should be applied in this context.

中文翻译：

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心脏移植后经胸超声心动图的正常参考范围

背景

心脏移植（HTx）后的心脏功能受多种因素影响。通常使用经胸超声心动图对其进行评估，但目前在这种情况下无法获得参考值。本研究的主要目的是在临床稳定的HTx患者中得出超声心动图参考值，包括腔室大小和功能，包括心脏力学。

方法

该研究招募了124位健康的HTx患者进行了前瞻性检查。根据当代指南，患者接受了全面的二维超声心动图检查。将结果与健康受试者的公认参考值进行比较。

结果

与指南相比，HTx患者的心房尺寸更大。左心室（LV）舒张期体积较小，并且LV壁厚度增加。关于左室功能，射血分数（62±7％，P  <.01）和整体纵向应变（-16.5±3.3％，P  <.0001）均较低。右心室（RV）尺寸的所有测量值均大于参考值（P  <.0001），并且RV功能的所有测量值均降低（三尖瓣环平面收缩期偏移15±4 mm [ P  <.0001]，RV收缩期组织多普勒速度10±6 cm / sec [ P  <.0001]，面积变化率40±8％[ P  <.0001]和RV自由壁应变-16.9±4.2％[ P <.0001]）。先前有排斥反应的患者的射血分数和LV总体纵向应变显着降低。

结论

这项研究的结果表明，稳定的HTx患者和健康受试者之间常规使用的超声心动图测量值的分布是不同的。尤其是明显的RV和心房容积明显增大，LV和RV纵向应变均轻度降低。观察到的差异可能在临床上与HTx患者的评估有关，在这种情况下应采用特定的参考值。