Alteration of Cardiac Deformation in Acute Rejection in Pediatric Heart Transplant Recipients

摘要: The objective of this study is to assess changes in cardiac deformation during acute cellular- and antibody-mediated rejection pediatric HT recipients. Pediatric recipients aged ≤18 years with at least one episode biopsy-diagnosed from 2006 2013 were included. Left ventricular systolic S (SS) SR (SSr) data acquired using 2D speckle tracking on echocardiograms obtained within 12 h right endomyocardial biopsy. A mixed effect model was used compare CR (Grade ≥ 1R), AMR (pAMR ≥ 2), (CR positive) versus no (Grade 0R pAMR 0 or 1). total 20 subjects (10 males, 50%) 71 events 35, 49%; 21, 30% 15, 21%) met inclusion criteria. median time first biopsy for analysis 5 months (IQR 0.25–192 months). Average LV longitudinal SS SSr reduced significantly (SS: −17.2 ± 3.4% vs. −10.7 ± 4.5%, p < 0.001 SSr: −1.2 ± 0.2 s− 1 −0.9 ± 0.3 s− 1; p < 0.001) all types. short-axis radial only compared (p = 0.04), while average circumferential 18.9 ± 4.2% 20.8 ± 8.8%, p = 0.03 1.35 ± 0.8 s− 1 1.54 ± 0.9 s− 1; p = 0.03). In recipients, types, CR. further differentiated between a significant reduction seen as This novel finding suggests mechanistic differences AMR- CR-induced myocardial injury which may be useful non-invasively predicting the type