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Evaluation of longitudinal myocardial deformation by 2-dimensional speckle-tracking echocardiography in heart transplant recipients: relation to coronary allograft vasculopathy.

https://arctichealth.org/en/permalink/ahliterature267989
Source
J Heart Lung Transplant. 2015 Feb;34(2):195-203
Publication Type
Article
Date
Feb-2015
Author
Tor Skibsted Clemmensen
Brian Bridal Løgstrup
Hans Eiskjær
Steen Hvitfeldt Poulsen
Source
J Heart Lung Transplant. 2015 Feb;34(2):195-203
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Allografts
Coronary Angiography
Coronary Artery Disease - diagnosis - epidemiology - physiopathology
Coronary Vessels - ultrasonography
Denmark - epidemiology
Echocardiography - methods
Female
Graft Survival
Heart Transplantation
Heart Ventricles - physiopathology - ultrasonography
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Stroke Volume
Transplant Recipients
Ventricular Function, Left - physiology
Abstract
Coronary allograft vasculopathy (CAV) in heart transplant (HTx) recipients is characterized by diffuse affection of epicardial and intramyocardial coronary vessels. Despite significant CAV and anticipated affected myocardial function, left ventricular ejection fraction (LVEF) is often within the normal range, indicating the need of more sophisticated non-invasive methods to detect impaired myocardial function caused by CAV. Global longitudinal strain (GLS) represents a new echocardiographic measurement of systolic myocardial deformation. The aim of the study was to evaluate the relation between GLS measured by 2-dimensional speckle-tracking echocardiography and CAV in HTx patients.
The study included 178 HTx patients and 20 healthy, age-matched individuals. All patients had an extensive echocardiographic evaluation and coronary angiography assessing CAV. CAV was classified according to International Society of Heart and Lung Transplantation classification (CAV0-3).
CAV was seen in 38.8% of patients. Compared with controls (-20.6% ± 1.4%), GLS was significantly reduced according to the degree of CAV (CAV0, -16.7% ± 2.4%; CAV1, -15.2% ± 2.9%; CAV2-3, -14.0% ± 3.8%; controls, -20.6% ±1.4%; pTREND
Notes
Comment In: J Heart Lung Transplant. 2015 Feb;34(2):158-6025511745
PubMed ID
25108908 View in PubMed
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Marked variations in serial coronary artery diameter measures in Kawasaki disease: a new indicator of coronary involvement.

https://arctichealth.org/en/permalink/ahliterature122372
Source
J Am Soc Echocardiogr. 2012 Aug;25(8):859-65
Publication Type
Article
Date
Aug-2012
Author
Frédéric Dallaire
Anne Fournier
Jolène Breton
Thanh-Diem Nguyen
Linda Spigelblatt
Nagib Dahdah
Author Affiliation
Division of Pediatric Cardiology, Department of Pediatrics, Laval University Hospital, Faculty of Medicine, Laval University, Quebec, Quebec, Canada.
Source
J Am Soc Echocardiogr. 2012 Aug;25(8):859-65
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Child, Preschool
Comorbidity
Coronary Artery Disease - epidemiology - ultrasonography
Coronary Vessels - ultrasonography
Echocardiography - statistics & numerical data
Female
Humans
Infant
Male
Mucocutaneous Lymph Node Syndrome - epidemiology - ultrasonography
Prevalence
Quebec - epidemiology
Reproducibility of Results
Risk factors
Sensitivity and specificity
Abstract
The long-term risk of patients with Kawasaki disease is not well defined. A great proportion of patients with Kawasaki disease have important variation of their coronary artery (CA) diameters, but the significance of this variation is not known. The aim of this study was to test the hypothesis that patients within the normal range of CA diameters but with important Z-score variation have a stronger inflammatory response and increased resistance to treatment than those without such Z-score variation.
A retrospective study was conducted in 197 patients with Kawasaki disease with serial echocardiograms up to 12 months after diagnosis. Patients with occult CA dilatation (variation > 2 Z-score units but within the normal range) were compared with patients with definite CA dilatation (Z score > 2.5) and with patients with normal CA for resistance to treatment and systemic inflammatory parameters.
A total of 63 patients (32.0%) were identified with Z scores always within the normal range but with important variation of CA diameter during follow-up (occult dilatation). There was a strong statistically significant trend of increasing inflammatory marker levels across patient categories (normal > occult dilatation > definite dilatation). Furthermore, resistance to intravenous immunoglobulin therapy was significantly increased in patients with occult dilatation compared with patients with normal CAs (relative risk, 2.6; 95% confidence interval, 1.21-5.44; P = .006).
The suggested definition of occult CA dilatation identified patients with CA involvement currently unrecognized per the current guidelines. These patients might be at a higher CA risk than previously thought.
PubMed ID
22824173 View in PubMed
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