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Echocardiography to predict left ventricular filling pressure for long-term paediatric heart transplant patients

Published online by Cambridge University Press:  06 May 2024

Fahad A. Alfares Open the ORCID record for Fahad A. Alfares [Opens in a new window] ,
Chetan Nanjegowda ,
Sethuraman Swaminathan ,
Juanita Hunter ,
Jaime Alkon ,
Satinder Sandhu  and
Paolo Rusconi
Fahad A. Alfares*
Affiliation:
Pediatric Cardiology Unit, Department of Cardiac Sciences, King Saud University, Riyadh, Saudi Arabia Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
Chetan Nanjegowda
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
Sethuraman Swaminathan
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
Juanita Hunter
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
Jaime Alkon
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
Satinder Sandhu
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
Paolo Rusconi
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA
*
Corresponding author: F. A. Alfares; Email: falfares@ksu.edu.sa
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Abstract

Objectives:

Left ventricular diastolic dysfunction is a recognised sequela following transplantation in paediatric heart transplant patients. Traditional echocardiographic indices do not correlate well with left ventricular filling pressure immediately after transplantation. This study aimed to assess whether these indices have any long-term correlation after transplantation in paediatric patients.

Methods:

A retrospective chart review of 41 patients who had a heart transplant before the age of 24 years was performed. The median time since the transplantation was 11 years. Data obtained from surveillance cardiac catheterisation and echocardiographic examination were reviewed. Traditional echocardiographic indices of diastolic function were compared with the pulmonary capillary wedge pressure and left ventricular end-diastolic pressure obtained from cardiac catheterisation.

Results:

The median age at transplant was 12.1 years, and the median time since transplant was 11 years. Eighteen patients (43%) had a history of at least one rejection episode and 12 patients (29%) had a history of cardiac allograft vasculopathy. There was no correlation between mitral inflow E velocity, mitral E/A ratio, tissue Doppler velocities, mitral E/e’ (mitral inflow E velocity to mitral annular velocity), and elevated pulmonary capillary wedge pressure or elevated left ventricular end-diastolic pressure. There was no correlation between mitral valve deceleration time or isovolumetric relaxation time with elevated pulmonary capillary wedge pressure or elevated left ventricular end-diastolic pressure.

Conclusion:

Our findings suggest that traditional echocardiographic indices of diastolic function do not correlate well with elevated invasive pulmonary capillary wedge pressure or elevated left ventricular end-diastolic pressure in paediatric heart transplant patients’ long-term post-transplantation.

Keywords

diastolic functionheart transplantpaediatricsechocardioghrapy
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 6
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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