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Changes in left and right ventricular function of donor hearts during the first year after heart transplantation
  1. Sorel Goland1,
  2. Robert J Siegel2,
  3. Kevin Burton2,
  4. Michele A De Robertis2,
  5. Asim Rafique2,
  6. Ernst Schwarz2,
  7. Kaveh Zivari2,
  8. James Mirocha2,
  9. Alfredo Trento2,
  10. Lawrence S C Czer2
  1. 1Heart Institute, Kaplan Medical Center, Rehovot, Israel
  2. 2Division of Cardiology, Department of Cardiothoracic Surgery, Cardiac Non-Invasive Laboratory, Cedars-Sinai Medical Center, Los Angles, California, USA
  1. Correspondence to Sorel Goland, Heart Institute, Kaplan Medical Center, Rehovot 76100, Israel; sorelgoland{at}yahoo.com or sorel_g{at}clalit.org.com

Abstract

Objective Expected values of tissue Doppler imaging (TDI) velocities and myocardial performance index (MPI) after heart transplantation (HTx) have not been evaluated. This study assessed left and right ventricular (LV and RV) structure and function during the first year after HTx using these indexes.

Methods and results Echocardiography including MPI and TDI systolic (S′), early (E′) and late (A′) diastolic velocities of RV and LV were performed in 20 donors (mean age 35±13 years) and serially in 20 recipients (mean age 59±9 years) during the first year after HTx. Increase in LV mass occurred at 7 days, with normalisation at 3 months (p<0.001). An increase in MPI (p<0.001) and a decrease in E', S' velocities on TDI occurred at week 1 with gradual improvement during the first year (p<0.001). Normalisation of LV and RV MPI occurred at 6 months (p<0.001) and LV TDI velocities at 1 year (p<0.001). TDI velocities of both ventricles, however, at 1 year remained lower than at baseline. No patient had greater than grade IA rejection during the follow-up. No significant change was found in myocyte size within the first year. However, there was a 3.3-fold increase in fibrosis.

Conclusions This study is the first to identify the normal changes of TDI and MPI of both ventricles during the first year after HTx. An increase in LV mass and impairment of bi-ventricular systolic and diastolic function occur early after HTx with gradual improvement during the first year. No significant changes in myocyte size were observed, but there was a substantial increase in fibrosis.

  • Donor
  • echocardiography (three-dimensional)
  • function
  • heart failure
  • heart transplant
  • heart transplantation
  • heart transplant pathology
  • left ventricle
  • right ventricular
  • transplantation

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Footnotes

  • Funding This work was supported in part by a grant from the Rav-Noy Foundation and the Save-A-Heart Foundation, Cedars-Sinai Medical Center, Los Angeles, California, USA.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Cedars-Sinai Medical Center, Los Angles, California, USA.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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