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Background: The contractile pattern of the right ventricle is altered after orthotopic heart transplantation (OHT). It is unclear whether the current echocardiographic parameters for right ventricular assessment defined in non-transplant individuals are generalizable to transplanted patients.
Methods: This was a retrospective analysis of 43 patients that underwent OHT between 2005 and 2013 at the University of Nebraska Medical Center. Reduced right ventricular ejection fraction (rRVEF) was identified by cardiac MRI and compared with echocardiographic parameters of right ventricular function. Normal and abnormal for each modality was based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Results: In total, 7 of the 43 patients (11%) had at least one instance of rRVEF as defined by cardiac MRI. The most specific parameter in identifying rRVEF was fractional area of change (FAC), 98.4%. The specificity was significantly lower for tricuspid annular plane systolic excursion (TAPSE) and tricuspid dissue doppler imaging (S'). The sensitivity was 100%, 87.5% and 50% for TAPSE, S’ and FAC, respectively. However, FAC had the greatest area under the curve (Figure 1A) and most linear correlation with cardiac MRI (Figure 1D).
Conclusions: FAC is the most useful parameter in identifying rRVEF post-OHT compared to cardiac MRI. TAPSE and S’ disproportionately suggest rRVEF that may be due to geometric rather than functional differences.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Innovative Use of Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1197-220
- 2017 American College of Cardiology Foundation