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Altered Biatrial Phasic Function after Heart Transplantation in Children.
J Am Soc Echocardiogr. 2020 Jul 08 [Online ahead of print]JA

Abstract

PURPOSE

We used two-dimensional echocardiographic speckle-tracking to investigate whether left and right atrial (LA and RA) phasic function in pediatric heart transplantation (HT) patients is altered and explored the relationship to HT-related clinical variables.

METHODS

Eighty-six subjects (36 HT and 50 normal children) were prospectively enrolled in two centers. Clinical data included age at HT, bypass time, ischemia time, donor age, and incidence of rejection. Atrial deformation indices including strain and strain rates (SRs) were measured using two-dimensional echocardiographic speckle-tracking. Components of phasic atrial function-reservoir (εr, SRr), conduit (εcd, SRcd), and booster (εct, SRct) were calculated. Comparisons with controls were made using t test or Kruskal-Wallis test, and correlations to clinical variables were explored.

RESULTS

The mean age and body surface area of HT subjects were 10.2 ± 6.2 years and 1.2 ± 0.6 m2, respectively. The mean heart rates were higher in HT (96 ± 18 vs 88 ± 21 in controls). There were reductions in RA and LA reservoir (εr, SRr), conduit (εcd, SRcd), and booster (εct, SRct) function in HT compared with controls. There was no relationship of LA and RA deformation indices with mean age at HT, bypass time, or ischemia time. The LA εcd correlated weakly with donor age (r = -0.49, P = .04) and RA SRr, and SRcd showed association with duration of HT (P < .05). Nineteen HT recipients had follow-up studies 0.24 ± 0.18 years after the first examination, and deformational indices were not significantly changed.

CONCLUSIONS

Atrial strain determination is feasible in pediatric HT recipients and demonstrates disruption of reservoir, conduit, and booster function of both atria in this population; we speculate this may be a consequence of ventricular diastolic dysfunction.

Authors+Show Affiliations

Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri.The Blalock Taussig Thomas Heart Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.The Blalock Taussig Thomas Heart Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska College of Medicine and Children's Hospital and Medical Center, Omaha, Nebraska.Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska College of Medicine and Children's Hospital and Medical Center, Omaha, Nebraska.Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri.Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska College of Medicine and Children's Hospital and Medical Center, Omaha, Nebraska.Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany.Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska College of Medicine and Children's Hospital and Medical Center, Omaha, Nebraska.The Blalock Taussig Thomas Heart Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: skutty1@jhmi.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32653298

Citation

Parthiban, Anitha, et al. "Altered Biatrial Phasic Function After Heart Transplantation in Children." Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, 2020.
Parthiban A, Jani V, Zhang J, et al. Altered Biatrial Phasic Function after Heart Transplantation in Children. J Am Soc Echocardiogr. 2020.
Parthiban, A., Jani, V., Zhang, J., Li, L., Craft, M., Barnes, A., Ballweg, J. A., Schuster, A., Danford, D. A., & Kutty, S. (2020). Altered Biatrial Phasic Function after Heart Transplantation in Children. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. https://doi.org/10.1016/j.echo.2020.04.029
Parthiban A, et al. Altered Biatrial Phasic Function After Heart Transplantation in Children. J Am Soc Echocardiogr. 2020 Jul 8; PubMed PMID: 32653298.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered Biatrial Phasic Function after Heart Transplantation in Children. AU - Parthiban,Anitha, AU - Jani,Vivek, AU - Zhang,Jin, AU - Li,Ling, AU - Craft,Mary, AU - Barnes,Aleissa, AU - Ballweg,Jean A, AU - Schuster,Andreas, AU - Danford,David A, AU - Kutty,Shelby, Y1 - 2020/07/08/ PY - 2019/04/16/received PY - 2020/04/24/revised PY - 2020/04/25/accepted PY - 2020/7/13/entrez PY - 2020/7/13/pubmed PY - 2020/7/13/medline KW - Atrial strain KW - Atrial strain rate KW - Heart transplantation KW - Pediatric cardiology KW - Two-dimensional speckle-tracking JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography JO - J Am Soc Echocardiogr N2 - PURPOSE: We used two-dimensional echocardiographic speckle-tracking to investigate whether left and right atrial (LA and RA) phasic function in pediatric heart transplantation (HT) patients is altered and explored the relationship to HT-related clinical variables. METHODS: Eighty-six subjects (36 HT and 50 normal children) were prospectively enrolled in two centers. Clinical data included age at HT, bypass time, ischemia time, donor age, and incidence of rejection. Atrial deformation indices including strain and strain rates (SRs) were measured using two-dimensional echocardiographic speckle-tracking. Components of phasic atrial function-reservoir (εr, SRr), conduit (εcd, SRcd), and booster (εct, SRct) were calculated. Comparisons with controls were made using t test or Kruskal-Wallis test, and correlations to clinical variables were explored. RESULTS: The mean age and body surface area of HT subjects were 10.2 ± 6.2 years and 1.2 ± 0.6 m2, respectively. The mean heart rates were higher in HT (96 ± 18 vs 88 ± 21 in controls). There were reductions in RA and LA reservoir (εr, SRr), conduit (εcd, SRcd), and booster (εct, SRct) function in HT compared with controls. There was no relationship of LA and RA deformation indices with mean age at HT, bypass time, or ischemia time. The LA εcd correlated weakly with donor age (r = -0.49, P = .04) and RA SRr, and SRcd showed association with duration of HT (P < .05). Nineteen HT recipients had follow-up studies 0.24 ± 0.18 years after the first examination, and deformational indices were not significantly changed. CONCLUSIONS: Atrial strain determination is feasible in pediatric HT recipients and demonstrates disruption of reservoir, conduit, and booster function of both atria in this population; we speculate this may be a consequence of ventricular diastolic dysfunction. SN - 1097-6795 UR - https://www.unboundmedicine.com/medline/citation/32653298/Altered_Biatrial_Phasic_Function_after_Heart_Transplantation_in_Children L2 - https://linkinghub.elsevier.com/retrieve/pii/S0894-7317(20)30290-X DB - PRIME DP - Unbound Medicine ER -
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