Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients

Ritu Sachdeva, Sadia Malik, Paul M. Seib, Elizabeth A. Frazier, Mario A. Cleves

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

The purpose of the study is to determine the association of Doppler Tissue Imaging (DTI) and catheter-derived measures with rejection in pediatric heart transplant (PHT) recipients and to determine any correlation between DTI and catheter-derived measurements. Sixty echocardiograms were prospectively performed in 37 PHT recipients at the time of surveillance cardiac biopsy. During right-heart cardiac catheterization, sequential pressures of the right heart and pulmonary capillary wedge pressures (PCWP) were measured. DTI was performed to obtain peak systolic (S'), early (E') and late (A') diastolic velocities (cm/s) at tricuspid annulus, septum and mitral annulus. Septal S' and tricuspid annular A' were associated with rejection, but had low sensitivity and specificity. Elevated lateral mitral E/E' did not predict rejection. The mean pulmonary capillary wedge pressure (PCWP) and cardiac index were similar in those with and without rejection. The lateral mitral and septal E/E' did not correlate with PCWP. Some DTI-derived measures were altered during rejection, but were not clinically useful predictors of rejection. Catheter-derived measures were not significantly altered during rejection and did not correlate with DTI-derived measures. None of these measures can replace the current practice of performing cardiac biopsy for surveillance of rejection.

Original languageEnglish (US)
Pages (from-to)947-954
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume27
Issue number7
DOIs
StatePublished - Oct 1 2011

Keywords

  • Catheterization
  • Doppler tissue imaging
  • Pediatric heart transplant
  • Rejection

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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